A team of doctors in the Netherlands has reported a strange case of foreign language syndrome (FLS).  A 17-year-old boy who suffered an injury while playing soccer was admitted to a hospital for knee surgery. The operation was successful, but the moment the patient woke up and spoke for the first time after the surgery, everyone around him was shocked.

The boy didn’t recognize his parents, believed he was in the United States, forgot his native language (Dutch), and spoke only English — the foreign language he had learned and practiced solely at school. 

“The patient’s native language was Dutch, and his second language was English. The latter was acquired in a nonbilingual school during regular English classes. He had only spoken English during these classes. He had spoken Dutch exclusively throughout his life, including on the morning of his surgery,” the Doctors note in their case report.

This is an extremely rare phenomenon as to this date, only eight such cases of FLS have been reported, and this is the first-ever in a teenager, the report adds.

What happened next?

At first, the medical staff thought the patient was in delirium, a temporary state of confusion and agitation that some people experience when waking up from anesthesia after surgery. This condition typically lasts for up to 30 minutes. But in this case, even after a couple of hours, the patient didn’t show any signs of recovery.

The doctors called a team of psychiatrists to diagnose the patient. They asked the boy some questions, which he answered in English but with a Dutch accent. After some hours, he also replied with some answers in Dutch, but every time he did so, he struggled. 

The psychiatrists concluded that the patient had FLS — a rare condition in which a person suddenly starts speaking a different language or with a foreign-sounding accent. Since it typically occurs due to brain damage, stroke, migraine, or head trauma, the doctors decided to conduct a complete neurological examination of the patient. 

Surprisingly, no anomaly was found in his brain.

The patient began to understand Dutch 18 hours after his knee surgery. Moreover, the next day (about 24 hours after the operation) when his friends came to visit him, he was talking to them in Dutch, just as he used to. 

“The neurologist saw no indication for further diagnostics; therefore, no electroencephalogram (EEG), neuroimaging, or neuropsychological examinations were performed near the event, and the patient was discharged a day later,” the doctors said.

The patient remembered everything

The 17-year-old boy experienced a temporary FLS condition, but what’s even more surprising is that he remembers every detail of the things that happened to him after the knee surgery.

“Interestingly, during the mental status examination, the boy revealed that he was aware he had been speaking and only able to understand English in the immediate postoperative period. In addition, he remembered that he had been unable to recognize his parents and that he had believed he was in the USA,” the doctors said.

Three weeks after the surgery, the doctors did a follow-up on the patient and they found that he didn’t face any difficulties in understanding or speaking Dutch. He is completely normal now and living a healthy life.

However, his case study remains puzzling for doctors. Even to this date, they don’t know how and why the teenager developed FLS with a normal brain without any trauma.

You can read the full case report here.