A healthy 21-year-old woman went to a U.S. Air Force hospital to have painful wisdom teeth removed. When she came out of general anesthesia, her native English had been pushed aside, and she was fixated on a second language, a rare phenomenon known as foreign language syndrome.
Air Force oral surgeons described the episode in a case report in the Journal of Oral and Maxillofacial Surgery. What makes it stand out is the company it keeps. By the authors' count, only 12 cases had been reported before, and none involved a woman or an oral and maxillofacial procedure.
The report was published online in August 2024 and appeared in the journal's December 2024 issue. A review of foreign language syndrome cases published in Neurology International in 2025 has since added it to a table of known cases, listing the episode as lasting about 24 hours and resolving without any intervention.
A Routine Extraction with a Very Unusual Wake-Up
The patient, an active-duty Air Force member, arrived at David Grant Medical Center at Travis Air Force Base in April 2022 with a referral for wisdom tooth removal. She had pain, swelling, and trismus, a stiffness that limits how far the jaw can open. Otherwise, she was healthy, according to the report by Andrew T. Mathis, Jakub F. Pietrowski, and David Y. Ahn. She took no medications, had no allergies, and had never had surgery or anesthesia before.
During her pre-surgery assessment, she spoke English fluently with no noticeable foreign accent. After the procedure, that changed. The published summary does not name the second language, and the 2025 review lists it only as an unspecified non-native language.
That distinction matters. Foreign language syndrome is different from foreign accent syndrome, in which people keep speaking their native language but sound as if they come from somewhere else. In foreign language syndrome, a person who knows more than one language switches to one they learned later, often imperfectly, while the mother tongue temporarily drops away.
The Same Sedatives Used in Everyday Oral Surgery
The authors flagged a detail that may catch the attention of anyone who has been sedated in an oral surgeon's chair. Among earlier cases, volatile inhaled anesthetics were used in at least two. At least five cases, however, occurred without them, involving intravenous drugs such as midazolam, fentanyl, and propofol, the same medications commonly used for outpatient oral surgery. The 2025 review lists those three drugs for this patient.
Earlier cases span several languages. According to the review's table, a 64-year-old English speaker spoke Norwegian for about five hours after bladder cancer surgery, and a 55-year-old English speaker recovering from throat surgery switched to Spanish for 5 to 10 minutes. The review notes that most anesthesia-related episodes clear on their own within minutes to hours, and it cites an earlier analysis of eight cases in which episodes lasted from about 25 minutes to 28 hours.
None of this suggests the drugs are dangerous for most people. Wisdom tooth removal under sedation is extremely common, and documented cases of this language switch remain a tiny handful. The authors wrote that their purpose was not to explain the syndrome but to raise awareness that it can follow oral surgery.
Why Would the Brain Drop Its First Language?
No one knows exactly what causes the switch. The case report points to one hypothesis. Broca's area, a key speech-production region, handles languages learned in roughly the first five years of life, while languages picked up around age 7 or later are stored more widely across the cortex, including outside Broca's area.
If anesthesia temporarily quiets Broca's area while other regions come back online, the idea goes, a later-learned language could surface first. It remains a hypothesis rather than a proven mechanism.
Other researchers see a link to emergence delirium, the confusion some patients experience as anesthesia wears off. Doctors in the Netherlands raised that possibility in a 2022 report about a 17-year-old who could communicate only in English for about a day after orthopedic surgery, instead of his native Dutch. The 2025 review adds that brain scans in these patients typically show no structural damage and that no functional brain imaging has yet been captured during an episode, which leaves the underlying biology unresolved.
What Oral Surgeons Are Being Told
The authors' practical message is aimed at oral surgeons. Based on the pattern in reported cases, they wrote in the study abstract that the syndrome may be difficult to diagnose but appears to be self-limiting, typically resolving within about 24 hours. They went further, stating that no stroke workup is warranted and that sending the patient home with a phone follow-up the next day is likely appropriate.
That advice rests on a very small number of cases. The 2025 review notes that clinicians often order brain imaging to rule out stroke or bleeding when speech changes suddenly. It also describes a rarer case tied to brain injury that did not resolve over four years of follow-up. Any unexpected speech or language change after anesthesia should be assessed by the treating medical team, which can decide what testing is needed.
For now, the case adds a first female patient and a first oral surgery setting to a very short list, along with a reminder that the brain's handling of language can behave in surprising ways as anesthesia wears off.
Key Questions Answered
What is foreign language syndrome?
It is a rare condition in which a person who knows more than one language suddenly and involuntarily uses a non-native language while access to the native language is temporarily lost or suppressed. It differs from foreign accent syndrome, in which people keep their language but sound foreign.
What happened to the woman after wisdom tooth surgery?
After general anesthesia for wisdom tooth removal, the healthy 21-year-old Air Force member became fixated on a non-native language. A 2025 review lists the episode as lasting about 24 hours and resolving without intervention.
How rare is it?
The case report's authors counted only 12 previously reported cases, none involving a woman or oral and maxillofacial surgery.
Which anesthesia drugs have been involved?
Some earlier cases involved inhaled anesthetics, but at least five occurred with intravenous drugs such as midazolam, fentanyl, and propofol, which are common in outpatient oral surgery. No drug has been shown to cause the syndrome.
Should people worry about sedation for wisdom teeth?
The syndrome is extremely rare, and anesthesia-related episodes have generally been temporary. People with questions about sedation should raise them with their oral surgeon or anesthesia provider before the procedure.
Published by Medicaldaily.com
