ObjectiveThe goal of this investigation was to describe the neurologic and psychiatric findings in a patient with foreign accent–like syndrome occurring during episodes of psychotic exacerbation.BackgroundForeign accent syndrome has been reported in several patients with disorders such as cerebral infarction, cerebral hemorrhage, and head trauma but not in a patient whose primary problem was psychosis. Most patients with this syndrome exhibit some degree of aphasia, and some are dysarthric.MethodA schizophrenic patient with foreign accent–like syndrome occurring during a psychotic exacerbation was evaluated by examination and interview, language testing, magnetic resonance imaging, electroencephalography, and other investigative methods.ResultsThe patient exhibited a prominent British accent, which persisted throughout the duration of his psychotic exacerbation and resolved with improvement of his psychosis. Magnetic resonance imaging revealed no lesions, and no abnormality of language or articulation was present. A single-photon emission computed tomography scan could not be obtained.ConclusionsThis represents the first reported case of a patient with foreign accent–like syndrome during psychotic exacerbations.