The Clinical Spectrum of Autoimmune-Mediated Neurological Diseases in Patients Presenting to a Tertiary Care Hospital in Rawalpindi

Autoimmune-mediated neurological diseases (AMNDs) affect the central and peripheral nervous systems through inflammation and demyelination, leading to diverse neurological dysfunctions. Their heterogeneous clinical presentations complicate diagnosis, and epidemiological data in adult Pakistani populations remain scarce. Objectives: To determine the frequencies of different AMNDs among adult patients presenting to a tertiary care hospital in Rawalpindi. Methods: This cross-sectional study was conducted at the Department of Neurology, Pak Emirates Military Hospital, Rawalpindi, from 1st April to 20th September 2025, including 177 adult patients consecutively presenting with neurological symptoms suggestive of autoimmune etiology. The diagnosis was made on the basis of clinical manifestations supported by MRI, cerebrospinal fluid analysis, and autoantibodies. The analysis was performed using SPSS version 27.0. Results: The mean age of the patients was 47.9 ± 11.4 years. The majority of patients were female 108 (61%). Multiple Sclerosis was the most frequent diagnosis (27.1%), followed by autoimmune encephalitis (20.3%), Guillain-Barré syndrome (16.4%), myasthenia gravis (13.6%), and neuromyelitis optica spectrum disorder (10.7%). Anti-ganglioside antibodies showed the highest seropositivity (12.4%), while MRI and CSF abnormalities were observed in 33.9% and 38% of patients, respectively. Significant associations were found between disease type and age (p=0.018), gender (p=0.006), residence (p=0.041), family history (p=0.032), and symptom duration (p=0.014). Conclusions: Multiple Sclerosis, autoimmune encephalitis, and Guillain-Barré syndrome are the most prevalent AMNDs in this population, with distinct demographic patterns and variable diagnostic findings. Early recognition and integrated diagnostic approaches are essential to improve patient outcomes.