This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased.
Foreign accent syndrome (FAS) is a rare speech disorder characterized by a change in prosody and other speech variables yielding altered phonetic characteristics that are perceived as a foreign accent. Lesions associated with FAS typically involve left frontoparietal regions. However, 2 reported left-hemispheric stroke patients presenting with FAS also had hypoperfusion of the right cerebellum on 99mTc ECD SPECT imaging, presumably from diaschisis. In both cases, there was a close parallel between the normalization of the cerebellar perfusion and resolution of the clinical syndrome up to 3 years later despite continued hypoperfusion of left hemispheric structures.1,2 The authors argued that the temporal association between the clinical improvement and the right cerebellar perfusion suggested a functional role of the cerebellum in this speech disorder. We describe a unique case that provides convergent evidence for a causative role of the cerebellum in FAS.
Case report.
A right-handed English-speaking woman was 58 years of age at the time of her left frontoparietal infarct (figure, A), presenting with right upper limb paresis and aphemia. Within hours, the patient’s paresis resolved to a slight hand ataxia and her speech sounded like English spoken with an unlearned accent. Workup suggested an embolic event, and she was discharged on warfarin. The foreign accent persisted for approximately 3 years until she had a right inferior cerebellar hemorrhage (figure, B–D) from accidental excessive anticoagulation. Following this second stroke, the patient and her family noted that the foreign accent was no longer perceptible in her speech. …
AAN Members
We have changed the login procedure to improve access between AAN.com and the Neurology journals. If you are experiencing issues, please log out of AAN.com and clear history and cookies. (For instructions by browser, please click the instruction pages below). After clearing, choose preferred Journal and select login for AAN Members. You will be redirected to a login page where you can log in with your AAN ID number and password. When you are returned to the Journal, your name should appear at the top right of the page.
AAN Non-Member Subscribers
Purchase access
Letters: Rapid online correspondence
REQUIREMENTS
You must ensure that your Disclosures have been updated within the previous six months. Please go to our Submission Site to add or update your Disclosure information.
Your co-authors must send a completed Publishing Agreement Form to Neurology Staff (not necessary for the lead/corresponding author as the form below will suffice) before you upload your comment.
If you are responding to a comment that was written about an article you originally authored:
You (and co-authors) do not need to fill out forms or check disclosures as author forms are still valid
and apply to letter.
Submission specifications:
- Submissions must be < 200 words with < 5 references. Reference 1 must be the article on which you are commenting.
- Submissions should not have more than 5 authors. (Exception: original author replies can include all original authors of the article)
- Submit only on articles published within 6 months of issue date.
- Do not be redundant. Read any comments already posted on the article prior to submission.
- Submitted comments are subject to editing and editor review prior to posting.
