What Is Foreign Accent Syndrome?

Medically Reviewed by Melinda Ratini, MS, DO on December 20, 2022
4 min read

Imagine you wake up and how you pronounce words suddenly sounds completely different, almost foreign, from the last time you spoke. For example, your American English accent sounds British. This might seem bizarre, but it’s a rare motor speech disorder aptly called foreign accent syndrome (FAS). 

It’s not the same as moving to a different country for a few years and developing a new accent. A number of things can cause this. The most common cause is brain damage that stems from a stroke or traumatic brain injury. 

The condition was first described in 1907 by a French neurologist named Pierre Marie. Since then, just a little over 100 cases have been reported.  

With FAS, your native language will remain the same. In fact, you’ll still most likely be able to speak in full sentences without messing up the order of words. The only difference will be what your accent sounds like. 

Some of the accent switches caused by FAS that have been reported include American English to British, Japanese to Korean, and Spanish to Hungarian.

FAS can also cause certain speech changes such as small errors in how you pronounce a word. For example, instead of saying “ball,” the word you speak might sound like “pall.”

You might also inject “uh” a lot more when you speak, substitute, delete, or distort certain words and have difficulty properly pronouncing long, multisyllable words. 

You’re more likely to develop FAS if you hurt the part of your brain, usually Broca’s area, that controls the melody of your speech and rhythm of the words when you speak. FAS also affects the way in which you place your tongue in your mouth as you talk, which can alter your accent. 

Causes include:

  • Severe head injury such as from a car crash
  • Stroke
  • A tumor or growth in your brain
  • Multiple sclerosis
  • Bleeding in your brain (brain hemorrhage)
  • Conversion disorder (when an emotional stress causes physical symptoms)

A 2019 study that looked at 112 FAS cases found that the majority were adult, right-handed women who were native English speakers. And they had never had any contact with the country or geographical area of the accent they picked up. 

According to research, you’re also most likely to have other neurological conditions along with FAS. 

You have a higher risk to develop FAS if you have:

  • Aphasia, a brain disorder that affects your ability to understand written and spoken language, the way you write, and how you communicate.
  • Apraxia, a rare neurological condition that affects your ability to carry out learned movements on command such as tying your shoes
  • A high risk for stroke
  • Dysarthria, or speech difficulties caused by brain damage
  • Agraphia, a condition that causes you to lose your ability to write
  • Alexia, a condition that affects your ability to read aloud or understand written words, or both

Your doctor will do a detailed physical exam and focus on how you use the facial muscles that help you speak. They’ll also ask about your personal and family medical history to rule out any genetic conditions. They might also do mental health exams. 

To check for brain injury, they’ll run imaging tests like:

  • CT scan
  • MRI scan
  • PET scan
  • Single photo-emission computer tomography scan (SPECT)

Along with your doctor, you’ll also need to be seen by a speech-language pathologist who’ll test your language skills. This can include:

  • Tests to check your speech-language patterns with audio and video recordings
  • Reading, writing, and comprehension tests

If you have FAS, you may revert back to your native accent in some cases. It might be a permanent change for others. Speech and language therapy can help you manage your symptoms to a certain degree. 

It can include:

  • Learning how to move your lips and jaws when you speak
  • Mental health counseling to help you adjust to the changes FAS causes

Out of the 112 cases that were observed in the 2019 study, about 7 out of 10 cases were caused by a stroke. Among them, about 40% were diagnosed with mutism (unable or refusing to speak) along with additional neurological issues. Around 20% of them saw their accents return to somewhat normal. 

About 2 in 10 people had functional FAS after a stroke, meaning they could speak but their accents had switched. Among them, nearly 40% saw their FAS symptoms go away. 

If your FAS is rooted in a psychological cause, experts say there’s a greater chance that your accent will go back to normal. 

There’s no way to prevent FAS. However, since strokes and head injuries are the most common causes, you can take steps to lower your risk for them.