A person with foreign accent syndrome may speak with the accent of someone from a different country or region. An injury to the central nervous system can cause this.

With this condition, a person who is a native language speaker may also begin sounding like someone who speaks the language as a second or third language.

In most cases, an injury to the central nervous system causes foreign accent syndrome. However, a variant of this diagnosis called psychogenic foreign accent syndrome causes a person to speak with a foreign accent for psychological, not physiological, reasons.

Foreign accent syndrome is different to when a person spends a significant amount of time in another country and develops an accent.

People with foreign accent syndrome are not faking. Rather, changes in their nervous system — or, in the case of psychogenic foreign accent syndrome, their mental health — cause them to speak differently.

Keep reading to learn more about this rare neurological condition.

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A history of head or facial injuries is a possible cause of foreign accent syndrome.

Foreign accent syndrome causes a person to speak in their usual language but with a foreign accent. The accent remains relatively consistent over time and is not something the person is “faking.”

People with foreign accent syndrome usually have brain damage or a neurological condition, though some have mental health conditions.

People with foreign accent syndrome may not perfectly replicate the accent their speech resembles. However, the changes in their speech tend to remain fairly consistent. People do not typically switch between accents or have an accent only sometimes.

A 2019 report on 49 people with foreign accent syndrome found that most reported having a foreign accent for 2 months to 18 years, with a mean length of 3 years.

Foreign accent syndrome is very rare. In fact, one 2018 analysis estimates that as few as 80 people worldwide have the condition.

For this reason, doctors often study people who present with this symptom and then publish the results. Some published cases are below:

  • One of the earliest cases involved a Norwegian woman who was hit with shrapnel during World War II. The German accent she developed due to brain damage caused people to ostracize her.
  • A 2016 case report details the story of a 34-year-old African American woman whose doctors related her foreign accent syndrome to schizophrenia. She showed up in the emergency room (ER) with a British accent, despite never having lived in Britain. She had faced immense financial and emotional distress in the months before this visit to ER, and doctors diagnosed her with schizophrenia.
  • According to a 2018 case report, a 65-year-old Spanish-speaking woman with multiple sclerosis (MS) began speaking in Spanish with an English accent. MS destroys the myelin that coats the nerves, disrupting their ability to send signals. MRI scans revealed demyelination in her brain.
  • According to a 2011 National Public Radio story, an American English-speaking woman developed a foreign accent following dental surgery. The story reports an accent that sounded both Irish and British. The woman reports developing the accent immediately upon waking from surgery. The change persisted even after the swelling in her mouth healed and she recovered from surgery.

Foreign accent syndrome has two main causes: neurological conditions or damage and mental health conditions.

The following sections will discuss these in more detail.

Neurological conditions or damage

Most people with foreign accent syndrome have a neurological condition or a history of head or facial injuries. Some factors that might cause foreign accent syndrome include:

  • a blow to the head or face
  • surgery to the face or brain
  • MS
  • brain tumors
  • migraine

A 2019 analysis of 49 people with foreign accent syndrome found that the most common linked conditions were:

  • severe headaches or migraine (15 people)
  • stroke (12 people)
  • surgery to the face or mouth (6 people)
  • seizures (5 people)

Injuries to the brain from falls, cancer, and other factors may change the way the brain processes language, as well as the way it controls speech.

Mental health conditions

Some people with foreign accent syndrome have mental health conditions such as schizophrenia, depression, or a history of severe trauma.

Some have a conversion disorder. This occurs when a person experiences intense psychological pain that manifests as physical symptoms.

The primary symptom of foreign accent syndrome is speaking in an accent associated with a country where the person has never lived or a language they have never spoken.

For example, a native English speaker who has never left the United States may begin speaking English with a Spanish accent.

Most people with foreign accent syndrome also show symptoms of a psychological or neurological condition. They might have schizophrenia or depression, a recent brain injury, or a medical condition, such as MS or dementia, that damages the brain.

A person whose foreign accent changes slightly or who develops a new accent after living abroad does not have foreign accent syndrome.

A person with foreign accent syndrome may seek treatment because they or someone they know noticed the change in their speech.

In some cases, however, foreign accent syndrome presents secondary to another symptom. In this scenario, a person seeking emergency psychiatric care might also have an unusual accent, or a head injury survivor may develop a new speech pattern.

No specific test can assess for foreign accent syndrome. Instead, doctors work to diagnose the cause using a variety of tests, including:

  • blood tests, to test for infections and some illnesses
  • brain scans, such as MRI scans, to look for lesions or damage in the brain
  • a lumbar puncture, to test for infections in the spinal fluid and to check for signs of certain central nervous system conditions
  • a complete medical history, to determine when the symptoms appeared and what may have caused them
  • psychiatric screenings, such as assessments for depression and schizophrenia

If a doctor cannot find a physiological cause, they will usually diagnose a person with psychogenic foreign accent syndrome and work to identify a possible psychological cause.

Foreign accent syndrome itself is not dangerous. However, it may warn of a serious medical condition, such as a tumor or lesion in the brain, dementia, or MS. Treatment will therefore focus on addressing the cause of the foreign accent syndrome.

A doctor might prescribe medication for conditions such as MS or surgery for certain brain growths. When there is a psychiatric cause, a doctor may recommend therapy, medication, or both.

Many causes of foreign accent syndrome are not curable, though medication can help manage the symptoms.

In most cases, a doctor will recommend speech therapy to help a person regain their normal habits. When the cause of foreign accent syndrome is unclear — such as in the case of the woman who developed it following dental surgery — speech therapy may be the only treatment option.

Foreign accent syndrome is a very rare condition.

The cause is usually neuroglial damage (from trauma), a neurological condition, or a mental health condition.

Ignoring an unexplained foreign accent might mean delaying treatment for a serious medical condition.

Anyone experiencing a sudden and unexplainable change in accent should seek the advice of a healthcare professional.