Patient with Foreign Accent Syndrome in Post-infarct Thrombotic Stroke: A Case Report

Abstract

Background: Stroke is the second leading cause of death in the world and the leading cause of disability worldwide. One of the disabilities is language disorder. Foreign Accent Syndrome (FAS) is a clinical condition associated with a noticeable change of accent, affecting verbal communication and social interaction skills. By identifying this case earlier, we hope the patient’s daily living is less disrupted.

Case: A 54-year-old woman came with complaints of weakness and tingling in the right limbs accompanied by a change in language accent. Weakness in the right limbs was felt since 4 years ago, then 1 year later the patient began to experience a change in the speech accent, from a Javanese accent to a Madurese accent, where previously the patient had never lived or studied Madurese. The results of the neurobehavior examination showed the patient had disturbances in the language and memory domain. MRI revealed cerebral infarction in the bilateral hippocampi, small vessel ischemic in the bilateral frontal lobes, and corona radiata.

Discussion: The accent change, known as FAS experienced by the patients, is thought to be due to neurological causes, which was stroke. In a study using a lesion network mapping approach, it was concluded that the lesion causing accent disorder was located within a single network in the bilateral frontal lobe. In line with the existing theory, the MRI results in this patient showed ischemia in the blood vessels of the bilateral frontal lobes.