Let’s imagine Patient X: a 58-year-old woman who has lived in England all her life, has never been abroad and has always had a distinctive Newcastle accent. After a serious stroke, Patient X woke up almost unable to speak. Over time, her speech improved and became fully intelligible. However, one dramatic difference remained: she was now speaking in a foreign accent. Some said she sounded Italian, others suggested Slovakian; one listener even felt it was Jamaican. Patient X remained oblivious to this accent change, until she was played a tape recording of herself speaking and was “devastated”.

Patient X is likely to be suffering from ‘Foreign Accent Syndrome’, an extremely rare condition affecting only a handful of people around the world. The syndrome is characterised by a perceived foreign accent in speech following brain damage, normally due to a stroke or traumatic brain injury.

The accent change is to do with speech being altered in terms of timing, intonation, and tongue placement. Anomalies involving the stress on words and the rhythm of speech result in listeners perceiving the speech as having a foreign accent. Speech remains highly intelligible and often patients are otherwise unchanged, saying the same phrases and words as they did before, but in an unfamiliar accent. 

In almost all cases, the left hemisphere of the brain is damaged – the side focussed on language production and processing. The precise location of the damage is more difficult to pinpoint, but various regions of the motor cortex have been shown to be affected, suggesting the syndrome could be due to damage to brain mechanisms underlying the physical production of speech. Symptoms may last for months and then disappear, or be permanent. Treatments include speech therapy (the patient is taught how to move the lips and jaw better during speech) or counselling; otherwise, very little help exists and there is a profound lack of research into the syndrome.

One of the first and best known cases reported was a native Norwegian woman who was struck in the head by a shell fragment during an air raid in 1941. Upon recovering consciousness and eventually regaining speech, she developed what sounded like a strong German accent. This was particularly problematic, as Norway was under German occupation at the time. She complained bitterly of being mistaken for a German in shops, as the assistants would sell her nothing.

In comparison with other neurological disorders, patients with Foreign Accent Syndrome are able to go about their daily lives relatively normally. Although a new (and foreign) accent poses no practical problems, one sufferer explained that she felt her social identity had changed and she no longer felt a part of her community, highlighting the emotional burden of the syndrome.