Affiliations: Department of Surgery, Division of Speech Pathology
and Audiology, Duke University Medical Center, NC, USA | Department of Medicine, Division of Neurology, Duke
University Medical Center, NC, USA | Department of Communications, North Carolina State
University, Duke University Medical Center, NC, USA | Department of Psychiatry, Division of Medical
Psychology, Duke University Medical Center, NC, USA | Department of Medicine, Division of Hematology, Duke
University Medical Center, NC, USA
Note: [] Corresponding author: Harrison N. Jones, PhD, Duke University
Medical Center, 155 Baker Hose, Trent Dr., DUMC 3887, Durham, NC, 27710, USA.
Tel.: +1 919 684 6271; Fax: +1 919 684 8298; E-mail: harrison.jones@duke.edu
Abstract: Multiple reports have described patients with disordered
articulation and prosody, often following acute aphasia, dysarthria, or apraxia
of speech, which results in the perception by listeners of a foreign-like
accent. These features led to the term foreign accent syndrome (FAS), a speech
disorder with perceptual features that suggest an indistinct, non-native
speaking accent. Also correctly known as psuedoforeign accent, the speech does
not typically match a specific foreign accent, but is rather a constellation of
speech features that result in the perception of a foreign accent by listeners.
The primary etiologies of FAS are cerebrovascular accidents or traumatic brain
injuries which affect cortical and subcortical regions critical to expressive
speech and language production. Far fewer cases of FAS associated with
psychiatric conditions have been reported. We will present the clinical
history, neurological examination, neuropsychological assessment,
cognitive-behavioral and biofeedback assessments, and motor speech examination
of a patient with FAS without a known vascular, traumatic, or infectious
precipitant. Repeated multidisciplinary examinations of this patient provided
convergent evidence in support of FAS secondary to conversion disorder. We
discuss these findings and their implications for evaluation and treatment of
rare neurological and psychiatric conditions.
