Introduction.

Foreign Accent Syndrome (fas) is a rare entity. Patients develop changes in rhythm and tone of speech (prosody), perceived as a different accent than their native language. There are three types of fas: neurogenic, psychogenic and mixed. fas is rare in ms, and even more so as a first manifestation.

Objective.

Review of fas, types, pathophysiology, presentation in ms and evolution.

Summary.

Cortical lesions in ms are correlated with cognitive impairment, motor disability, psychiatric symptoms, language 3 disorders, speech impairment, and seizures. Most of the published cases of fas have suffered injury in the dominant hemisphere, in the prerrolandic cortex and adjacent areas, frontal motor association areas, in the putamen, basal ganglia, and theposterior fossa (protuberance, cerebellum). Different etiologieshave been reported, vascular being the most frequent. We present the case of a 44-year-old woman who first manifestation was fas, previously interpreted as a brain ischemia and finally diagnosed as multiple sclerosis. This case had partial improvement of the symptoms after phonoaudiologic rehabilitation.

Conclusions.

fas is rarely observed as an initial presentation of ms debut, as cortical symptoms are atypical relapses. An inflammatory demyelinating cause should be considered in young patients lacking vascular risk factors, and must be supported by complementary neuroimaging studies.

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