The diagnosis and management of complex neurological conditions such as New-Onset Refractory Status Epilepticus (NORSE) and central nervous system (CNS) infections caused by non-tuberculous mycobacteria (NTM) pose substantial difficulties in intensive care units (ICUs).

This article combines a case report and a literature review that explores the diagnostic dilemmas and therapeutic strategies for these critical conditions.

We report the case of an 83-year-old female with chronic granulomatous meningitis secondary to NTM, presenting a challenging diagnostic and complex management complexity typical of such a rare disease through a period time of five years.

Her case emphasized the importance of a multidisciplinary approach in such cases, as the interplay between neurology and intensive care was vital.

The need for new molecular diagnostic technologies is shown to be of high significance in identifying the causative pathogens and improving patient outcomes in these rare but critical conditions.

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