This is a case report on a 57-year-old lady who presented to the Psychiatry Department of Tallaght Hospital after being referred by Neurology Department. She was initially attending Neurology Department for idiopathic Parkinson’s disease which was later refuted as there was no objective evidence of response to treatment. She attended the A&E department with altered consciousness and headache, but her computed tomography of the brain was normal, and was diagnosed with migraine. But it was noted that she was reporting paranoia and auditory hallucinations, and her family had noticed marked change in her accent. On assessment in psychiatric outpatient she was noted to have psychotic symptoms. She reported these symptoms to be ongoing for the last 4 years, but have worsened to an extent that she was extremely distressed by them. She had acquired a Scottish accent. The change in accent coincided with worsening of her psychotic symptoms. Based on her assessment she was diagnosed with schizophrenia and was commenced on olanzapine. Not only her psychotic symptoms resolved but also her accent reverted to native form.

This paper is a personal exploration of one woman's lived experience with aphasia, verbal dyspraxia and accent change following cryptogenic ischaemic stroke. I share insights into my experiences, especially of an emotional and cultural nature, after growing up multilingual in Europe and then living with communication changes in a predominantly English-speaking country (Australia) and following return to Europe. My formal reflections commenced 15 years after the stroke and, following my previous studies in the medical field, multimodal visual arts and philosophy, were initiated in the context of postgraduate study emphasising a multimodal arts-based, collaborative, experiential approach to reconstructing understandings of experiences, values and meanings. Central features of this personal narrative include emergent, iterative enquiry and learning: emergent, in that the enquiry was open-ended, allowing for an element of surprise and the opportunity to pursue unanticipated directions; iterative, in that it involved knowingly experiencing and conversing about what had been discovered in order to engage with the process of continuous meaning-making. Following the enquiry, fellow students provided intersubjective responses to issues that touched personal reflection on their part. In particular, I highlight one fellow student's intersubjective responses that touched me in return by providing especially pertinent understanding and images.

Karanasios P, Loukopoulou P, Zampakis P, Tiligadas T, Makridou A, Doukas V, Argyriou AA. Foreign accent syndrome caused by a left temporal–parietal ischaemic stroke.

Aim: We present the first reported case of a Greek patient with foreign accent syndrome (FAS) secondary to a left temporal-parietal ischemic stroke.

Case report: A 76 year-old right-handed, Greek in origin, male was referred because he had suddenly manifested changes in speech expression. The neurological examination revealed that his prior typical English-Australian accent resembled a mixture of Greek and English-Britain accent consistent with FAS, though he had visited only once Greece the last 15 years and never had been to United Kingdom.

Results: A brain Magnetic Resonance Imaging scan depicted an ischemic temporal lesion in the language-dominant left hemisphere, affecting the left posterior superior and middle temporal gyri, as well as the ipsilateral inferior supramarginal angular gyrus and posterior insula.

Conclusion: We might suggest that FAS in our patient was induced because of interrupted cortical-subcortical feedback pathways. The phenomenon of subcortical-cortical diaschisis might also have contributed to its clinical manifestation.