%0 Case Reports %T A case of presumed monostotic sphenoid fibrous dysplasia and abducens nerve palsy. %A Varma H %A Dolezal KA %J J AAPOS %V 24 %N 4 %D 08 2020 %M 32621988 %F 1.325 %R 10.1016/j.jaapos.2020.04.005 %X Monostotic fibrous dysplasia is a rare osteodystrophy that typically affects adolescents, manifests later in life, and may be associated with subclinical hormonal imbalances. It can lead to serious complications, including visual compromise. We report a case of presumed monostotic sphenoid fibrous dysplasia presenting with transient abducens nerve palsy and esotropia in an otherwise healthy infant. The mechanism of transient, noncompressive abducens nerve palsy is not clearly understood but has been theorized to be secondary to localized inflammation during a cycle of florid bone remodeling that includes cyst formation, microhemorrhage, and resorption.