Foreign accent syndrome and other neuropsychological sequelae of a parieto-occipital lesion following COVID-19 associated posterior reversible encephalopathy syndrome

Clin Neuropsychol. 2023 Aug;37(6):1321-1335. doi: 10.1080/13854046.2022.2108903. Epub 2022 Aug 24.

Abstract

Objective: We describe a previously fit and well 54-year-old female who acquired a range of severe and persisting neuropsychological impairments following a posterior reversible encephalopathy syndrome (PRES) complication of COVID-19. The initial presentation included aphasia, a neurogenic foreign accent syndrome (FAS) and a persisting complete cortical blindness from the underpinning parieto-occipital brain injury.

Method: Neuropsychological single clinical case report.

Results: The patient retained insight and made good early progress with their adjustment to the numerous losses caused by the COVID-19 associated acquired brain injury. Comprehensive neuropsychological investigation characterised an acalculia, along with deficits in focused, sustained and divided attention impacting on verbal memory, working memory and executive functioning, amongst numerous relative strengths.

Conclusion: Similar to PRES from other aetiologies, COVID-19 associated PRES can in some cases cause irreversible acquired brain injury. The diverse neuropsychological effects need to be comprehensively investigated and managed. This case adds to the neuropsychological literature on PRES, FAS and acquired brain injury as a rare complication of SARS-CoV-2.

Keywords: COVID-19; Posterior reversible encephalopathy syndrome; acalculia; acquired brain injury; foreign accent syndrome.

Publication types

  • Case Reports

MeSH terms

  • Brain Injuries* / complications
  • COVID-19* / complications
  • Female
  • Humans
  • Magnetic Resonance Imaging
  • Middle Aged
  • Neuropsychological Tests
  • Posterior Leukoencephalopathy Syndrome* / complications
  • Posterior Leukoencephalopathy Syndrome* / diagnostic imaging
  • SARS-CoV-2