Voluntary lid closing inability. Release of a compulsive reaction to the exploration of the environment.

Voluntary lid closing inability has been observed in two patients with right-sided frontal ischemic damage. The patients developed a transient inability to close their eyelids voluntarily at the same time as a transient forced grasping in the left hand and left hemiparesis not affecting the face. Automatic and reflex lid closures were retained as well as the ability to keep the eyes closed and to reopen them readily on command. In previous reports, inability to close eyelids voluntarily has been attributed to apraxia, paralysis, or motor impersistence. The localization of the lesion observed in our patients suggests other pathogenetic hypotheses similar to compulsive gaze. It is conceivable that the voluntary lid closing inability produced by frontal lobe lesions is due to the release of a compulsion to maintain the lids elevated in the waking state, because of the overactive effect of the visual stimuli.