Foreign Accent Syndrome Associated with Left Frontal Infarction in a Corrected Right-Hander

Abstract

We reported a patient with cerebral infarction who showed foreign accent syndrome (FAS) without dysarthria or other aphasic symptoms. A 47-year-old, corrected right-handed male developed articulatory difficulty and right hemiplegia with right central facial paralysis. MR imaging showed a left frontal infarction including the middle and inferior parts of the precentral gyrus. On the 5th day from onset, his speech showed mild anarthria including irregular articulatory distortion, substitution and repetition of initial sounds. The anarthria subsided during the next 10 days. Disturbance of prosody, however, became apparent in his spontaneous speech, reading aloud, and repetition of words and short sentences. Word accent often shifted and a word often had two units of accent. His rate of speech also increased. Both the examiners and his family members felt his speech seemed that of a foreigner. The dysprosodic speech subsided over the course of the next 6 months. The characteristics of the patient's dysprosody were different from either those of anarthria or those of aprosodia associated with right hemisphere lesions, and we considered his dysprosody to be foreign accent syndrome.