Foreign Accent Syndrome

Definition

Foreign accent syndrome (FAS) is a rare speech disorder. A person with it sounds as if they are speaking with an accent from another country.

Stroke—Common Cause of Foreign Accent Syndrome.

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Causes

FAS is caused by damage to the part of the brain that controls the rhythm and melody of speech. The damage may be due to:

• Stroke—this is the most common cause
• Trauma to the brain, such as a sharp blow to the skull
• Bleeding in the brain
• Multiple sclerosis
• A brain tumor

Risk Factors

Things that may raise the risk of FAS are:

• Being at a high risk for stroke
• Aphasia—problems understanding and expressing language
• Speech apraxia—problems making sounds, syllables, and words

Symptoms

Problems may last months, years, or may never go away. People with FAS speak in a distorted rhythm and tone, such as:

• Making vowel sounds that are longer and lower, such as changing English “yeah” to German “jah”
• Changing sound quality by moving the tongue or jaw differently while speaking
• Substituting words or using the wrong words to describe something
• Putting sentences together the wrong way

A person with FAS may be able to speak easily and have others understand them. The accent may also be within the same language, such as American-English to British-English.

Diagnosis

The doctor will ask about symptoms and health history. A physical exam will be done. It will focus on the muscles used to speak. A mental health exam may also be done to rule out other causes.

Language skills will be tested. This can be done with:

• Reading, writing, and language comprehension tests
• Recordings to look at speech patterns

Images will be taken of the brain. This can be done with:

• MRI scan
• CT scan
• Single-photon emission computed tomography (SPECT) scan
• PET scan

The brain's electrical activity may be measured. This can be done with an electroencephalogram (EEG).

FAS is rare. A team of specialists may be needed to make the diagnosis.

Treatment

The goal of treatment is to manage symptoms. Choices are:

• Speech therapy to learn how to better move the lips and jaw during speech
• Counseling to help cope with FAS

Prevention

There are no known guidelines to prevent FAS. Stroke is the most common cause. People who are at risk for stroke should talk to their doctor about taking steps to lower their risk.