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July 5, 2010

BehindTheMedspeak: Foreign Accent Syndrome

Long story short: Foreign Accent Syndrome (FAS) is a condition in which a foreign-sounding accent suddenly and unexpectedly appears after brain damage, such that native English speaking individuals when speaking English are perceived as non-native English speakers.

Often caused by a stroke, it can also follow traumatic brain injury.

It's so rare that fewer than 60 cases have been reported in the world medical literature since it was first described by neurologist G.H. Monrad-Krohn in a detailed 1947 case report published in the journal Brain.

Brigid Schulte's May 30, 2010 Washington Post story about a northern Virginia woman who acquired the syndrome illustrates just how problematic existence can be once fate plays out.

The article follows.


Fairfax woman developed Russian accent after head injury

Some people fall on their heads and wake up with their memory wiped out. A few revive with their personality totally changed. Others die. Robin Jenks Vanderlip fell down a stairwell, smacked her head and woke up speaking with a Russian accent.

Vanderlip has never been to Russia. She doesn't remember ever hearing a Russian accent. She lives in Fairfax County, was born in Pennsylvania and went to college on the Eastern Shore. Yet since that fall in May 2007, the first question she gets from strangers is: "Where are you from?"

"They say your life can change in an instant," she said in what sounds like a thick Russian accent. "Mine did."

For 42 years, Vanderlip, whose case is being studied at the National Institutes of Health and the University of Maryland, spoke with what NIH neurologist Allen R. Braun called a typical mid-Atlantic American accent.

But since the fall, her clipped way with consonants -- dropping the final "s" from some plural words, saying "dis" and "dat" for "this" and "that," or "wiz" instead of "with" -- and her formation of vowels -- "home" sounds more like "herm," "well" sounds like "wuhl" -- identify her more like a transplant from Moscow. The more fatigued she becomes, the thicker her accent grows.

What she has, Braun and other doctors say, is Foreign Accent Syndrome -- a rare and little-understood medical condition that can follow a serious brain injury. "It does sound strange," Braun said. "It certainly does sound like someone has a foreign accent."

The syndrome was first described by a neurologist in the closing days of World War II. A Norwegian woman hit in the head by shrapnel fell into a coma and woke up speaking with a German accent. Fellow Norwegians ostracized her as a result, according to the medical literature.

Fewer than 60 cases have since been reported worldwide. Puzzled doctors have studied a Louisiana woman who, after a brain injury, suddenly began speaking with a Cajun dialect; a woman from the Newcastle region of England who speaks like a Jamaican; and a Boston man who developed what sounded like a Scottish burr. There are Americans who have developed British-sounding accents, Britons who sound French, a Japanese stroke patient with a Korean accent, and a Spanish-speaker who acquired a thick Hungarian accent.

'Somebody's joke'

"The first time I heard about Foreign Accent Syndrome, I thought, 'This is not true; this is somebody's joke,' " said Julius Fridriksson, who has studied brain images of patients suffering from the malady at the University of South Carolina and who, as a native of Iceland, speaks English with a slight accent.

Then he began working with a patient who had spoken with a Southern U.S. accent all his life but woke from a stroke sounding like a proper British gent. "This was an accent he could not control."

Scientists are quick to point out that these are not bona-fide accents. (And none of the patients has spontaneously learned a foreign language.) Rather, in a way no one quite understands, the damage to the brain disrupts speech formation.

Shelia Blumstein, a Brown University linguist who has written extensively on Foreign Accent Syndrome, said sufferers typically produce grammatically correct language, unlike many stroke or brain-injury victims. But subtle changes in intonation and melody make syndrome sufferers sound foreign. No amount of therapy, she said, seems to reverse that.

"I did have one patient who had a stroke and developed Foreign Accent Syndrome, then had another stroke and it disappeared. Do dee do do. Do dee do doo," she said, imitating the "Twilight Zone" theme song. "There is still so much we don't know."

Two days after her fall, Vanderlip awoke unable to speak. A friend called 911, and Vanderlip was rushed to Fair Oaks Hospital, where an MRI showed she'd had a stroke. Working with a speech therapist, she could make rudimentary sounds and slowly relearn how to speak -- but with a Russian-sounding accent. When the accent remained even after Vanderlip regained speaking ability, a neurologist diagnosed Foreign Accent Syndrome.

Other changes

Since the fall, it's not only Vanderlip's accent that has changed. She has become forgetful and tires easily. Formerly loquacious and eloquent, even, friends say, she has become introverted, can't speak coherently for more than 35 minutes at a time and has lost her job as a regional manager for the nonprofit Operation Hope. A single mother of two, she lives off savings and disability payments.

Andrew Uscher, a longtime friend, said many of Vanderlip's friends have drifted away as she has struggled with her injury, financial issues and depression.

"When we go out, people just assume she's from another country," he said. "It bothers her -- not that people think she's foreign instead of American, but that it doesn't sound like her. It's not her normal speech pattern. And we all like to be true to who we are."

Nearly three years after she slipped on stairs at the National 4-H Council building in Chevy Chase, grabbed for a handrail, hurtled backward, hit her head and screamed for help, Vanderlip filed suit in Montgomery County Circuit Court against the 4-H, alleging that the stairs were unsafe and seeking at least $1 million in damages. The 4-H Council did not respond to a request to comment.

On her home answering machine, Vanderlip has preserved her old voice as a greeting. "Please leave your message and we'll get back to you as soon as we can." She sounds confident, articulate. And American. Her eyes redden when she hears it.

"When I sound different, people think that I'm different," she said. "To this day, my daughter is nervous about me going on field trips or working in the classroom, because she's a little embarrassed about how I sound." Vanderlip, who is studying brain-injury education George Washington University, said the incredulous looks she gets when she explains that she's a native-born American can get wearing.

She said she was devastated as she watched a Fox News Channel report on her lawsuit, with anchor Megyn Kelly repeatedly referring to her as "Inga from Sveden" and commentator Lis Wiehl saying: "She says she's going to be damaged because now some people think she has this nice, sexy Danish accent? I don't think so!"

Since she began speaking like a foreigner, Vanderlip sometimes wants to be anywhere but here. She and her children have started taking vacations abroad, where she can lose herself in a polyglot of accents. "I feel there's no one to judge me in a foreign country," she said. "I don't feel so out of place."


A 2005 story in the Kansas City Star documented another case.

The University of Texas at Dallas has created a website to serve as a support and resource for those with FAS and those close to them.

July 5, 2010 at 04:01 PM | Permalink


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Hmmm. OK, neurologically explainable, I'm sure, but it does make the spiritually whacky among us think other things. I wonder if Dan Akroyd would agree?

Posted by: tamra | Jul 6, 2010 4:02:04 PM

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