Foreign accent syndrome and psychosis: a case report

This is a case report on a 57-year-old lady who presented to the Psychiatry Department of Tallaght Hospital after being referred by Neurology Department. She was initially attending Neurology Department for idiopathic Parkinson's disease which was later refuted as there was no objective evidence of response to treatment. She attended the A&E department with altered consciousness and headache, but her computed tomography of the brain was normal, and was diagnosed with migraine. But it was noted that she was reporting paranoia and auditory hallucinations, and her family had noticed marked change in her accent. On assessment in psychiatric outpatient she was noted to have psychotic symptoms. She reported these symptoms to be ongoing for the last 4 years, but have worsened to an extent that she was extremely distressed by them. She had acquired a Scottish accent. The change in accent coincided with worsening of her psychotic symptoms. Based on her assessment she was diagnosed with schizophrenia and was commenced on olanzapine. Not only her psychotic symptoms resolved but also her accent reverted to native form.