Foreign accent syndrome following herpes simplex encephalitis: a case report

Foreign Accent Syndrome: insights from Neuroimaging and Pathophysiological mechanisms

Foreign Accent Syndrome (FAS) is a rare and complex speech disorder characterized by the sudden emergence of a foreign accent, typically following neurological events such as strokes, traumatic brain injuries, or neurodegenerative diseases. This comprehensive review explores the pathophysiology, neuroimaging findings, and prevalence of FAS. Neuroimaging studies, including MRI and fMRI, reveal significant brain reorganization predominantly in the left hemisphere, involving regions such as the superior temporal gyrus and medial frontal structures. Functional connectivity disruptions and the phenomenon of dynamic diaschisis are discussed as potential mechanisms. Additionally, the review addresses the psychogenic aspects of FAS, highlighting the role of psychological factors and functional neurological disorders. The high comorbidity of FAS with other conditions underscores the need for a multidisciplinary diagnostic and therapeutic approach. This paper aims to enhance the understanding of FAS and contribute to the development of effective treatment strategies for this unique speech disorder.

Effortful speech with distortion of prosody following SARS-CoV-2 infection

Coronavirus disease 2019 (COVID-19) infection has the potential for targeting the central nervous system, and several neurological symptoms have been reported in patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We describe a 48-year-old Caucasian woman with SARS-CoV-2 infection followed by the onset of word finding difficulties, effortful speech along with prosody distortion, in the context of spared semantic and syntactic abilities. The clinical picture, perceived as foreign accent syndrome (FAS), was not associated with structural and functional imaging changes or neurophysiological assessment abnormalities. We suggest that FAS, herein perceived as a regional accent syndrome, should be considered a possible additional neurological manifestation of SARS-CoV-2.