After the operation, the teenager forgot his native language and began to speak a foreign language: this is an extremely rare complication after anesthesia

After regaining consciousness after undergoing anesthesia, a 17-year-old boy from the Netherlands who had undergone knee surgery temporarily lost the ability to speak his native language, writes Live Science.

Photo: Ayse Ezgi Icmeli | Dreamstime.com

A teenager was hospitalized in the Netherlands for knee surgery after a football injury. The operation was successful, but when the patient woke up from anesthesia, he spoke only English and claimed to be in the United States. Before this incident, he had only used English in school lessons.

He did not recognize his parents and could not speak or understand spoken Dutch, his native language. According to the doctors' report, the patient had no history of psychiatric illness or nervous disorders in the family, except for his mother's history of depression.

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The nurse who first noticed the patient speaking English was not immediately concerned. She assumed he was experiencing delirium after anesthesia, a state of confusion that sometimes occurs after anesthesia. However, when, after several hours, medical staff were still unable to get the teenager to speak a word of Dutch, it was decided to call in psychiatrists for consultation.

Psychiatrists found the patient relaxed and attentive. He was able to answer questions, although he spoke English with a Dutch accent. Later, he began to give short answers in Dutch, but this was difficult for him.

Doctors diagnosed the young man with foreign language syndrome (FLS), a rare condition in which patients suddenly and involuntarily begin to use a second language instead of their native language for a period of time.

The neurologist found no abnormalities during the patient's full neurological examination. Eighteen hours after the operation, the teenager could understand Dutch, but still could not speak it. The day after the operation, friends came to visit him, and suddenly he could understand and speak his native language again.

Because the teenager spontaneously returned to his native language, doctors did not find it necessary to conduct additional neuropsychological tests, an electroencephalogram (EEG), or other types of brain examination. He was discharged three days after the operation.

FLS is extremely rare, with only about nine cases reported in the medical literature. Most of these were white males who switched between their native language and another language they learned later. They were generally not bilingual since childhood. In two cases, the race of the patients was not documented.

The authors of the report noted that FLS is rare in children and suggested that this was the first officially documented case of the syndrome in a teenager. In total, they found eight similar cases in which the patient switched to an entirely different language, rather than simply speaking with an accent.

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The latter is seen in a related condition called foreign accent syndrome, in which a person's speech changes in such a way that it sounds like they are speaking with a foreign accent. This phenomenon is often, but not always, associated with brain damage.

The exact cause of FLS is unknown, although there have been cases where the syndrome has manifested itself after anesthesia. The authors of the report noted that the effects of anesthesia on cognitive functions, as well as the process of removing anesthetics from the central nervous system, can lead to delirium upon recovery from anesthesia. For this reason, it is not yet clear whether FLS can be considered a separate condition or just a variant of such delirium.

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