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Behavioural Neurology
Volume 24, Issue 3, Pages 245-255
Clinical Note

Multidisciplinary Assessment and Diagnosis of Conversion Disorder in a Patient with Foreign Accent Syndrome

Harrison N. Jones,1 Tyler J. Story,2,3 Timothy A. Collins,2 Daniel DeJoy,3 and Christopher L. Edwards4,5

1Department of Surgery, Division of Speech Pathology and Audiology, Duke University Medical Center, NC, USA
2Department of Medicine, Division of Neurology, Duke University Medical Center, NC, USA
3Department of Communications, North Carolina State University, Duke University Medical Center, NC, USA
4Department of Psychiatry, Division of Medical Psychology, Duke University Medical Center, NC, USA
5Department of Medicine, Division of Hematology, Duke University Medical Center, NC, USA

Received 25 August 2011; Accepted 25 August 2011

Copyright © 2011 Hindawi Publishing Corporation and the authors. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Multiple reports have described patients with disordered articulation and prosody, often following acute aphasia, dysarthria, or apraxia of speech, which results in the perception by listeners of a foreign-like accent. These features led to the term foreign accent syndrome (FAS), a speech disorder with perceptual features that suggest an indistinct, non-native speaking accent. Also correctly known as psuedoforeign accent, the speech does not typically match a specific foreign accent, but is rather a constellation of speech features that result in the perception of a foreign accent by listeners. The primary etiologies of FAS are cerebrovascular accidents or traumatic brain injuries which affect cortical and subcortical regions critical to expressive speech and language production. Far fewer cases of FAS associated with psychiatric conditions have been reported. We will present the clinical history, neurological examination, neuropsychological assessment, cognitive-behavioral and biofeedback assessments, and motor speech examination of a patient with FAS without a known vascular, traumatic, or infectious precipitant. Repeated multidisciplinary examinations of this patient provided convergent evidence in support of FAS secondary to conversion disorder. We discuss these findings and their implications for evaluation and treatment of rare neurological and psychiatric conditions.