Foreign accent syndrome: anatomic, pathophysiologic and psychosocial considerations.

The appearance of new onset accented speech after brain insult has been rarely reported. Stroke is often responsible for the development of what has been termed foreign accent syndrome (FAS). Foreign Accent Syndrome was initially described by Pick in 1919, and further elaborated on by Monrad-Krohn in 1947. Manifestations include disruption in segmental and prosodic elements of speech, which results in a listener's perception of the speech as foreign. In the majority of these rare cases, the patients present without having been exposed to the accent in the past. However, reports of a spoken accent in which the patient had significant previous exposure to in the past have been described. We report a case in which a woman developed a Germanic accent coinciding with the return of speech several days following an embolic left-hemispheric cortical infarction. The underlying neuroanatomical and pathophysiological explanations are reviewed. Additionally, the psychosocial consequences of this rare phenomenon are discussed.