Foreign Accent Syndrome Caused by a Right Frontotemporal Meningioma: A Case Report

Foreign accent syndrome (FAS) is a rare speech disorder characterized by the unintended emergence of a foreign-sounding accent. While the precise pathophysiology of this syndrome has not been identified, FAS is thought to result from disruptions in pitch, inflection, stress, and articulation, leading listeners to perceive a foreign accent. It is most commonly associated with stroke, but can also result from traumatic brain injury, demyelinating disease, or neoplasm.

We present the case of a 59-year-old, right-handed, native English-speaking female from West Virginia who developed FAS secondary to a right frontotemporal meningioma. Clinical assessment, imaging, and surgical records were reviewed to evaluate the etiology and course of her speech disturbance.

Despite a complete and uncomplicated safe surgical resection, the speech disorder persisted. This outcome contrasts with other reported cases in which FAS resolved following treatment of the underlying lesion, suggesting potential irreversible disruption to the brain's speech networks.

This case highlights the complexity of FAS and contributes to the growing evidence that the disorder may result from disruption of distributed cortical and subcortical speech networks, rather than a single anatomical site. Furthermore, it highlights the possibility of persistent deficits even after successful treatment of the underlying structural lesion. These findings emphasize the importance of early recognition, supportive communication strategies, and multidisciplinary care planning, particularly by bedside nurses and Advanced Practice Registered Nurses, to address both the neurologic and psychosocial impacts of persistent speech disturbances like FAS.