Foreign accent syndrome (FAS) happens when you suddenly start to speak with a different accent. It’s most common after a head injury, stroke, or some other type of damage to the brain.

Although it’s extremely rare, it’s a real condition. Only about 100 people have been diagnosed with this condition since the first known case came to light in 1907.

Some examples of FAS include an Australian woman who developed a French-sounding accent after a car accident. In 2018, an American woman in Arizona woke up one day with a mixture of Australian, British, and Irish accents after falling asleep the night before with a headache.

It doesn’t just affect English speakers. FAS can happen to anyone and has been documented in cases and languages all over the world.

Let’s look into what causes it, how to recognize the symptoms, and what to do about it.

FAS seems to be related to conditions that affect and damage the Broca’s area of the brain. This area, on the left side of the brain, is typically linked to producing speech.

Conditions that can affect this area of the brain include:

Your natural accent results from a system of sound patterns in your native language that you unconsciously learn as you grow up. This is known as the phonetic system.

Your accent can change early in life as you’re exposed to different accents and speech patterns. But after your teenage years, your phonetic system stays mostly fixed.

That’s what makes FAS so puzzling. Its symptoms affect the entire patterning of your phonetic system. Here’s how it can show up in your speech:

  • You have trouble pronouncing clusters of sound like S-T-R in words like “struck.”
  • You have trouble with sounds that require you to “tap” your tongue behind your top front teeth, such as “t” or “d.”
  • You pronounce vowels differently, such as saying “yah” where you used to say “yeah.”
  • You may add, remove, or substitute sounds, such as saying “suh-trike” instead of “strike,” or using an “r” instead of an “l.”
  • Your pitch or tone on certain sounds may be different.

Other common symptoms of FAS:

  • You still speak your native language, but your accent sounds like that of someone who learned it as a second language later in life.
  • Your mental health is otherwise good, and no underlying mental health condition is leading to these accent changes.
  • Your errors are consistent across your entire phonetic system, giving the impression of a new “accent.”

It’s important to seek immediate medical attention any time you notice any changes to your normal speech. A change in the way you talk could be a sign of a more serious issue.

Your doctor will ask you about your symptoms and medical history. They may also examine the muscles you use when you talk.

Your doctor will likely need to see images of your brain. This can be done with a magnetic resonance imaging (MRI) scan or computed tomography (CT) scan. Both of these imaging tests can create detailed pictures of features inside your brain.

Because FAS is so rare, you’ll likely be seen by a team of specialists, including:

  • Speech-language pathologist. A specialist in speech and communication disorders may record you reading aloud to help diagnose the exact extent of your accent changes. They may also use other medical tests to help rule out other speech disorders with similar symptoms like aphasia.
  • Neurologist. A brain specialist can help identify possible causes of FAS symptoms. They will likely analyze your MRI or CT scans to try and interpret the link between your brain activity and your speech.
  • Psychologist. A mental health specialist can help you cope with the social and emotional effects of your new accent.

Treatment for FAS depends on the underlying cause. If there are no underlying conditions, possible treatments may include:

  • Speech therapyto learn how to recreate your previous accent through vocal exercises targeted at pronouncing sounds deliberately in your regular accent.
  • Counseling, therapy, or support groups to help you cope with any issues in your life that result from FAS. These issues may include people thinking that you’re faking your new accent or feelings that you’ve lost a part of your identity. Therapies may include behavioral therapy strategies to help you cultivate positive and healthy habits to combat negative or destructive thoughts, feelings, or habits.

If there is an underlying medical condition causing FAS, you may need one of the following treatments:

  • For stroke: anticlotting medications to prevent further strokes, or surgically removing the clot from the blood vessel
  • For brain injuries: antiseizure medications for major injuries, diuretics to reduce pressure in your brain, or surgery to repair any major damage
  • For aneurysms: surgical clipping of blood vessels to stop blood flow to an aneurysm
  • For MS: disease-modifying therapies to slow the progress of MS symptoms

Although it’s rare, FAS is a legitimate neurological condition that may have complications if the underlying cause isn’t diagnosed and treated.

If you notice any changes to your speech, get medical attention as soon as possible. The cause may not be serious or require treatment. But knowing what is causing the changes can help you get the right treatment, and prevent any further complications.