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

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:

• Posterior reversible encephalopathy syndrome
• foreign accent syndrome
• COVID-19
• acalculia
• acquired brain injury

Acknowledgements

We would like to sincerely thank the patient for their consent and permission to publish, the Neurorehabilitation team and Dr Peter Kralt (Consultant Neuroradiologist). We thank Dr Jason Price (Consultant Neuropsychologist) for his assistance with this report and are forever grateful for his extensive contributions to Neuropsychology within the South Tees Hospitals NHS Foundation Trust.

Disclosure statement

No potential conflict of interest was reported by the authors.

Funding

The author(s) reported there was no funding associated with the work featured in this article.