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Olguner Eker O, Gultekin M, Demirel Ozsoy S. Foreign Accent Syndrome After COVID 19 Infection: A Case Report. J Nerv Ment Dis 2023; 211:974-976. [PMID: 38015188 DOI: 10.1097/nmd.0000000000001617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2023]
Abstract
ABSTRACT Foreign accent syndrome (FAS) is an extremely rare disorder characterized by the appearance of speech changes that are perceived by the speaker and listeners as an acquired foreign accent. It still remains a poorly understood condition. Three main types of FAS have been reported in the medical literature as neurogenic, psychogenic, and mixed type. Psychogenic FAS includes all cases of FAS in which an organic cause has not been identified and a clear psychological factor has been identified after careful clinical, neurological, and neuroradiological examination. Although the COVID-19 epidemic, which has been ongoing since February 2020, primarily manifests itself with upper respiratory tract infection findings, it is seen that it also causes a wide range of neurological and psychiatric signs and symptoms. In this study, a 42-year-old female patient who started to have speech disorder after COVID-19 infection is presented in the light of clinical history, diagnosis, and differential diagnosis literature findings.
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Affiliation(s)
| | - Murat Gultekin
- Department of Neurology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
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Basagni B, Abbruzzese L, Priftis K, Damora A, Mancuso M. Acquired neurogenic foreign accent syndrome (ANFAS) as the sole outcome of the fibrinolysis procedure in a patient with acute stroke aphasia: a case study. Neurol Sci 2023; 44:1433-1435. [PMID: 36571642 DOI: 10.1007/s10072-022-06571-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Accepted: 12/17/2022] [Indexed: 12/27/2022]
Affiliation(s)
| | - Laura Abbruzzese
- Clinica di Riabilitazione Toscana, CRT, Montevarchi, Arezzo, Italy
| | | | - Alessio Damora
- Clinica di Riabilitazione Toscana, CRT, Montevarchi, Arezzo, Italy
| | - Mauro Mancuso
- Clinica di Riabilitazione Toscana, CRT, Montevarchi, Arezzo, Italy
- Department of General Psychology, University of Padua, Padua, Italy
- Azienda USL 9, Grosseto, Italy
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Demichelis G, Duran D, Ciullo G, Lorusso L, Zago S, Palermo S, Nigri A, Leonardi M, Bruzzone MG, Fedeli D. A multimodal imaging approach to foreign accent syndrome. A case report. Neurocase 2022; 28:467-476. [PMID: 36682057 DOI: 10.1080/13554794.2023.2168558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
This article describes a case of Foreign accent syndrome (FAS) in an Italian woman who developed a Canadian-like foreign accent without brain damage (functional FAS). The patient underwent an in-depth neuroimaging and (neuro)psychological evaluation. Language networks in the frontotemporal-parietal areas were typically activated bilaterally through fMRI and MEG assessments based on task-based data. Resting-state fMRI showed preserved connectivity between language areas. An obsessive-compulsive personality profile and mild anxiety were found, suggesting psychological and psychiatric factors may be relevant. Accordingly with our findings, multimodal imaging is beneficial to understand FAS neurological and functional etiologies.
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Affiliation(s)
- Greta Demichelis
- Department of Neuroradiology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Dunja Duran
- Clinical Epileptology and Experimental Neurophysiology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Giuseppe Ciullo
- Department of Neuroradiology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Lorenzo Lorusso
- Neuroscience Department, Neurology and Stroke Unit, A.S.S.T Lecco, Merate, Italy
| | - Stefano Zago
- U.O.C. Di Neurologia, IRCCS Fondazione Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Sara Palermo
- Department of Neuroradiology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy.,Dipartimento di Psicologia, Università degli Studi di Torino, Torino, Italy
| | - Anna Nigri
- Department of Neuroradiology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Matilde Leonardi
- Department of Neurology, Public Health, Disability Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Maria Grazia Bruzzone
- Department of Neuroradiology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Davide Fedeli
- Department of Neuroradiology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
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Geiser N, Kaufmann BC, Rühe H, Maaijwee N, Nef T, Cazzoli D, Nyffeler T. Visual Neglect after PICA Stroke-A Case Study. Brain Sci 2022; 12:brainsci12020290. [PMID: 35204053 PMCID: PMC8869876 DOI: 10.3390/brainsci12020290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 02/17/2022] [Accepted: 02/18/2022] [Indexed: 12/04/2022] Open
Abstract
After cerebellar stroke, cognition can be impaired, as described within the framework of the so-called Cerebellar Cognitive Affective Syndrome (CCAS). However, it remains unclear whether visual neglect can also be part of CCAS. We describe the case of a patient with a subacute cerebellar stroke after thrombosis of the left posterior inferior cerebellar artery (PICA), who showed a left-sided visual neglect, indicating that the cerebellum also has a modulatory function on visual attention. The neglect, however, was mild and only detectable when using the sensitive neuro-psychological Five-Point Test as well as video-oculography assessment, yet remained unnoticed when evaluated with common neglect-specific paper-pencil tests. Three weeks later, follow-up assessments revealed an amelioration of neglect symptoms. Therefore, these findings suggest that visual neglect may be a part of CCAS, but that the choice of neglect assessments and the time delay since stroke onset may be crucial. Although the exact underlying pathophysiological mechanisms remain unclear, we propose cerebellar-cerebral diaschisis as a possible explanation of why neglect can occur on the ipsilateral side. Further research applying sensitive assessment tools at different post-stroke stages is needed to investigate the incidence, lesion correlates, and pathophysiology of neglect after cerebellar lesions.
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Affiliation(s)
- Nora Geiser
- Neurocenter, Luzerner Kantonsspital, 6000 Lucerne, Switzerland; (N.G.); (B.C.K.); (H.R.); (N.M.); (D.C.)
- ARTORG Center for Biomedical Engineering Research, University of Bern, 3008 Bern, Switzerland;
| | - Brigitte Charlotte Kaufmann
- Neurocenter, Luzerner Kantonsspital, 6000 Lucerne, Switzerland; (N.G.); (B.C.K.); (H.R.); (N.M.); (D.C.)
- Department of Neurology, Inselspital, University Hospital, University of Bern, 3010 Bern, Switzerland
- Institut du Cerveau—Paris Brain Institute—ICM, Inserm, CNRS, Sorbonne Université, 75013 Paris, France
| | - Henrik Rühe
- Neurocenter, Luzerner Kantonsspital, 6000 Lucerne, Switzerland; (N.G.); (B.C.K.); (H.R.); (N.M.); (D.C.)
| | - Noortje Maaijwee
- Neurocenter, Luzerner Kantonsspital, 6000 Lucerne, Switzerland; (N.G.); (B.C.K.); (H.R.); (N.M.); (D.C.)
| | - Tobias Nef
- ARTORG Center for Biomedical Engineering Research, University of Bern, 3008 Bern, Switzerland;
| | - Dario Cazzoli
- Neurocenter, Luzerner Kantonsspital, 6000 Lucerne, Switzerland; (N.G.); (B.C.K.); (H.R.); (N.M.); (D.C.)
- ARTORG Center for Biomedical Engineering Research, University of Bern, 3008 Bern, Switzerland;
- Department of Psychology, University of Bern, 3012 Bern, Switzerland
| | - Thomas Nyffeler
- Neurocenter, Luzerner Kantonsspital, 6000 Lucerne, Switzerland; (N.G.); (B.C.K.); (H.R.); (N.M.); (D.C.)
- ARTORG Center for Biomedical Engineering Research, University of Bern, 3008 Bern, Switzerland;
- Department of Neurology, Inselspital, University Hospital, University of Bern, 3010 Bern, Switzerland
- Correspondence: ; Tel.: +41-41-205-5686
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Foreign accent syndrome associated with left insula infarction after COVID-19 pneumonia. CAN J EMERG MED 2021; 23:858-859. [PMID: 34403117 PMCID: PMC8369140 DOI: 10.1007/s43678-021-00196-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 08/05/2021] [Indexed: 11/12/2022]
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Clinical presentation of strokes confined to the insula: a systematic review of literature. Neurol Sci 2021; 42:1697-1704. [PMID: 33575921 PMCID: PMC8043872 DOI: 10.1007/s10072-021-05109-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 01/31/2021] [Indexed: 10/26/2022]
Abstract
BACKGROUND AND PURPOSE The insular cortex serves a wide variety of functions in humans, ranging from sensory and affective processing to high-level cognition. Hence, insular dysfunction may result in several different presentations. Ischemic strokes limited to the insular territory are rare and deserve a better characterization, to be quickly recognized and to receive the appropriate treatment (e.g. thrombolysis). METHODS We reviewed studies on patients with a first-ever acute stroke restricted to the insula. We searched in the Medline database the keywords "insular stroke" and "insular infarction", to identify previously published cases. Afterwards, the results were divided depending on the specific insular region affected by the stroke: anterior insular cortex (AIC), posterior insular cortex (PIC) or total insula cortex (TIC). Finally, a review of the clinical correlates associated with each region was performed. RESULTS We identified 25 reports including a total of 49 patients (59.7 ± 15.5 years, 48% male) from systematic review of the literature. The most common clinical phenotypes were motor and somatosensory deficits, dysarthria, aphasia and a vestibular-like syndrome. Atypical presentations were also common and included dysphagia, awareness deficits, gustatory disturbances, dysautonomia, neuropsychiatric or auditory disturbances and headache. CONCLUSIONS The clinical presentation of insular strokes is heterogeneous; however, an insular stroke should be suspected when vestibular-like, somatosensory, speech or language disturbances are combined in the same patient. Further studies are needed to improve our understanding of more atypical presentations.
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Foreign accent syndrome following herpes simplex encephalitis: a case report. Neurol Sci 2020; 41:2643-2645. [DOI: 10.1007/s10072-020-04403-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2019] [Accepted: 04/07/2020] [Indexed: 11/26/2022]
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Effortful speech with distortion of prosody following SARS-CoV-2 infection. Neurol Sci 2020; 41:3767-3768. [PMID: 32719902 PMCID: PMC7384723 DOI: 10.1007/s10072-020-04603-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Accepted: 07/14/2020] [Indexed: 11/27/2022]
Abstract
Coronavirus disease 2019 (COVID-19) infection has the potential for targeting the central nervous system, and several neurological symptoms have been reported in patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We describe a 48-year-old Caucasian woman with SARS-CoV-2 infection followed by the onset of word finding difficulties, effortful speech along with prosody distortion, in the context of spared semantic and syntactic abilities. The clinical picture, perceived as foreign accent syndrome (FAS), was not associated with structural and functional imaging changes or neurophysiological assessment abnormalities. We suggest that FAS, herein perceived as a regional accent syndrome, should be considered a possible additional neurological manifestation of SARS-CoV-2.
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