This reflex was observed in paralyzed patients who, when the examiner attempted to raise the eyelid, "involuntarily" closed the lid. The reaction is local, only slight on the paralyzed side but vigorous on the nonparalyzed side, may occur with the patient alert but more usually with obtundation, and does not invariably accompany hemiplegia. While most often encountered in vascular disease, blepharospasm occurred in various obtunded states of metabolic origin e.g., liver coma, CO2 narcosis, acidosis, and, in some cases, barbiturate stupor. In these it was present bilaterally. The author suggests that reflex blepharospasm reflects the temporary appearance of a rudimentary reflex which has lain submerged since the fetal period.