US cancer patient developed ‘uncontrollable’ Irish accent, doctors say

Man who developed foreign accent syndrome had never been to Ireland nor had any immediate Irish relatives

A cancer patient in the US developed what researchers say was an “uncontrollable Irish accent” during treatment, despite never having been to Ireland nor having immediate relatives from the country.

While still rare, cases of foreign accent syndrome (FAS) are more common in patients following strokes or head trauma, or who have psychiatric disorders, according to the experts from North Carolina’s Duke University and the Carolina Urologic Research Center of South Carolina.

During research, they could find only two similar cases to the “brogue” that evolved in the unnamed US patient, who was a man in his 50s with metastatic hormone-sensitive prostate cancer. Both other cases occurred in women cancer patients in their 50s and 60s between 2009 and 2011.

“To our knowledge, this is the first case of FAS described in a patient with prostate cancer and the third described in a patient with malignancy,” said the report, published in the British Medical Journal.


Some details of the man’s case, including his own nationality, were not revealed. But researchers said he maintained the Irish accent through about 20 months of treatment, and a gradual onset of paralysis, until his death.

Although the man had lived in England in his 20s, and had friends and more distant family members from Ireland, he had never visited Ireland, nor previously spoken in an Irish accent.

“He had no neurological examination abnormalities, psychiatric history or MRI of the brain abnormalities at symptom onset,” the report said.

“Despite chemotherapy, his neuroendocrine prostate cancer progressed resulting in multifocal brain metastases and a likely paraneoplastic ascending paralysis leading to his death.”

The authors suspect the paraneoplastic neurological disorder (PND), which develops in some cancer patients whose immune systems attack parts of the brain, spinal cord, nerves or muscles, was responsible.

“His accent was uncontrollable, present in all settings and gradually became persistent,” the report said.

Some who have developed FAS regain their original accent, either spontaneously or through intensive speech therapy, while for others the change is permanent.

The Guardian reported in 2010 the case of Sarah Colwill, a UK woman whose native west country accent was supplanted by a Chinese lilt about seven years after she suffered a stroke.

Four years earlier, another British woman and stroke victim, Linda Walker of Newcastle, realised her distinctive Geordie accent had given way to a Jamaican one.

“Not only did I have a stroke, but I got lumbered with this foreign accent syndrome as well,” she said at the time. “I didn’t realise what I sounded like, but then my speech therapist played a tape of me talking. I was just devastated.”

The US report said the case of the patient with the Irish accent underscored a need for more research.

“This unusual presentation highlights the importance of additional literature on FAS and PNDs associated with prostate cancer to improve understanding of the links between these rare syndromes and clinical trajectory,” the report concluded.