Foreign accent syndrome as a first sign of multiple sclerosis

Abstract

Background

Foreign accent syndrome (FAS) consists of a speech rhythm disorder different from dysarthia or aphasia. It is unusually met in multiple sclerosis (MS).

Objective

We report a case of FAS as an initial symptom of a MS.

Methods

A right-handed French woman developed an isolated German foreign accent. Brain magnetic resonance imaging (MRI), SPECT and analysis of CSF were performed.

Results

Brain MRI revealed a large hypersignal on T2-weighted images in the left prerolandic white matter. Single photon emission computed tomography showed a right prerolandic hypoperfusion. Unmatched oligoclonal bands in cerebrospinal fluid and occurrence of new abnormal hypersignals on the following MRI led us to diagnose MS.

Conclusion

FAS may be the first symptom of MS. It could result from extensive disturbances of brain function involving the right hemisphere.

Keywords

foreign accent syndrome functional imaging multiple sclerosis

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