Foreign accent syndrome due to conversion disorder: Phonetic analyses and clinical course

We describe the case of a 36-year-old native speaker of English who began using a foreign accent after abrupt onset of problems involving multiple sensory and motor functions. Neurological and neuroradiological examinations were within normal limits and no organic explanation for the difficulties could be identified. After eight months, the patient made a full recovery, allowing a detailed comparison between the speech patterns displayed during the period of foreign accent and those of her typical speech. Perceptual and acoustic analyses showed specific changes in vowel and consonant production and in intonation and stress patterns during the accented speech. These changes were similar to those described in the literature for patients with foreign accent syndrome following left cerebral hemisphere lesions. A review of presenting symptoms and clinical course of our case, however, indicated strong evidence for a conversion disorder. This case demonstrates that a psychogenic etiology for foreign accent syndrome should sometimes be considered and that the prognosis for recovery, including spontaneous remission, may be good in such cases. Differential diagnosis between psychogenic and neurogenic etiologies is discussed relative to the case presentation, history, course, and recovery.