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After waking up from knee surgery, a 17-year-old boy in the Netherlands stunned the medical staff at the hospital when he insisted he could only speak in a foreign language. Not only that, he “repeatedly” insisted that he was in the United States.
According to a report on the bizarre medical case by Live Science, in addition to only being able to speak a foreign language, the boy also did not recognize his parents and could not speak or understand his native language.
The strange case ended up being recorded by the doctors in the Journal of Medical Case Reports. In the report, the doctors wrote, “A 17-year-old Dutch Caucasian male lost the ability to understand and speak Dutch for 24 hours after an orthopedic surgery, combined with a brief confused state including disorientation of place and the inability to recognize his parents. During the period, he communicated in English, which he had learned during school classes but had never spoken outside of school. Further follow-up, including neuropsychological examination, revealed no indication of cognitive impairment.”
So what happened? The 17-year-old ended up being diagnosed with foreign language syndrome (FLS). Foreign Language Syndrome is when “patients switch from their native language and fixate for a period of time on a second language.”
“The primary cause of this switching remains unclear. There is speculation about the involvement of anesthesia, but its specific influence remains unclear,” the doctors wrote.
During the mental status examination, which took place approximately 18 hours after surgery, we found a relaxed, 17-year-old, well-groomed boy lying on the bed. We shook hands upon greeting. He made adequate eye contact and was open to communication. His attention could be attracted, and it was maintained well. During the interview, he was able to answer questions, but only in English, spoken with a Dutch accent. He gave only short answers in Dutch and did so with difficulty. His concentration seemed undisturbed. No thought delusions or hallucinations were observed during the conversation. His intelligence was estimated to be average. His mood was cheerful, with a normal affect. His use of the English language seemed adequate; his pronunciation and articulation were clear, with good intonation. His thinking, in terms of form and content, seemed undisturbed. He had a normal facial expression.
Approximately 18 hours postoperatively, the patient was able to understand Dutch but still could not speak it. The physicians involved observed that he spoke English adequately but appeared not to be fluent, while the nurses and his mother observed that he had the ability to speak the language fluently. Approximately 24 hours postoperatively, when some of his friends came to visit, he was able to spontaneously understand and speak Dutch again.
Making the case even more unusual, during a mental status examination the next day, “the boy revealed that he was aware he had been speaking and only able to understand English in the immediate postoperative period. In addition, he remembered that he had been unable to recognize his parents and that he had believed he was in the USA.”
The doctors also reported that they could only find eight other reported cases of FLS that were similar to that of their patient. They also believe they are the first to formally document a case of FLS in an adolescent.
“The exact pathophysiology of foreign language syndrome remains unclear, most specifically whether it is a syndrome of its own or a phenotype of emergence delirium,” they wrote. “There is still much to be learned, and further research is needed.”
Last month, in the case of another rare condition called Foreign Accent Syndrome, a woman revealed that after having a stroke she started speaking with an Italian accent and slips Italian phrases into conversations, despite never having visited the country.
“When a stroke affects parts of the brain that control speech — such as the tongue, lips, and vocal cords — it alters the strength, speed, and range of movements, which changes how speech sounds,” Professor Nick Miller, an expert in neuroscience at Newcastle University, told The Sun. “This creates subtle shifts in pronunciation and rhythm that might resemble a foreign accent.”
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