(Synonyms: anterior, expressive, or nonfluent aphasia). A primary deficit in language output (production), in which comprehension is largely unaffected. The defect may involve loss of all propositional speech, or the patient may use a small number of substantive words which are laboriously enunciated and not combined into grammatical phrases. The patient has difficulty naming objects and repeating words or phrases. The impairment in writing is usually equally severe. The patient is almost always aware of the problem. In right-handers, the lesion is in the left inferior frontal lobe; often there is accompanying paralysis of the lower face or hand on the right as the lesion commonly involves the neighboring primary motor cortex.