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Diagnosed With FND, Died From a Pulmonary Embolism: The Questions Allison Lawlor's Story Raises

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Allison Lawlor was 49 when she died in July 2022. For years, she had experienced severe neurological symptoms, including seizures, almost complete bodily numbness and disability that left her dependent on others for basic activities. Doctors eventually diagnosed her with Functional Neurological Disorder (FND). During a later hospital admission, she suffered a pulmonary embolism and died.

This is not about frightening people diagnosed with FND into believing they have some undiscovered, potentially fatal illness. It is about something far more important: premature diagnostic closure, and the danger of allowing a diagnosis to become more important than the evidence.

We do not know whether Allison's neurological symptoms and fatal pulmonary embolism were connected, whether her FND diagnosis was correct, or whether her death could have been prevented. The available reporting cannot establish those things. What it does provide is an opportunity to examine why diagnostic uncertainty matters, particularly when someone is profoundly disabled.

This is your life. You do not owe a diagnosis anything.


Allison's medical history

According to an October 2022 Daily Mirror report, Allison had spent years in and out of hospital. Her partner of 17 years, Paul Gallacher, gradually became her carer as her health deteriorated. She experienced episodes described as non-epileptic seizures, extensive numbness and severe difficulties eating, drinking and using the bathroom independently.

In July 2022, Allison was admitted to hospital with an infection and increasing forgetfulness. During a late-night FaceTime conversation, she told Paul that she was feeling much better. Approximately an hour later, the hospital informed him that she had suddenly deteriorated. Doctors managed to resuscitate her, but she sustained brain damage and subsequently died.

"She didn't die from the infection, she died from a pulmonary embolism. It shouldn't have happened, it was completely out of the blue."

A pulmonary embolism occurs when a blood clot obstructs an artery in the lungs, most commonly after travelling from a deep vein in the leg or pelvis. It can cause sudden cardiovascular collapse and death. The reported cause of Allison's death was a pulmonary embolism, not FND.


What was actually interpreted as FND?

One particularly interesting detail concerns Allison's seizures. Paul recalled doctors being puzzled because she remained aware during them:

"But even when she had seizures in front of doctors they were stumped as she was fully aware while having them."

Preserved awareness is not exclusive to functional seizures. Certain epileptic seizures, particularly focal aware seizures, can occur without loss of consciousness. Awareness alone cannot reliably distinguish epileptic from functional events. Whether Allison underwent video-EEG monitoring, and what the results showed, is not reported.

Her extensive numbness raises similar questions. Functional sensory disturbances can involve widespread sensory loss, but so can neurological conditions affecting the brain, spinal cord or peripheral nervous system. The distribution of symptoms, examination findings and associated abnormalities are essential to determining what they mean.

Paul explained that he recognized similarities between Allison's symptoms and patients featured in a television documentary about FND. He subsequently pursued specialist assessment, during which doctors reportedly investigated conditions including multiple sclerosis before concluding that she had FND.

What the article never explains is which positive clinical signs supported that conclusion. Were specific functional neurological findings demonstrated, or was the diagnosis reached largely because investigations for other conditions had not identified an explanation?

Those are very different diagnostic approaches. Excluding multiple sclerosis does not establish FND, and unexplained symptoms do not automatically become functional. The newspaper does not provide enough information to determine how Allison's diagnosis was established, although the missing details may well exist in her medical records.

That is a recurring limitation of FND reporting: the diagnosis is presented as settled, but the evidence behind it is rarely available for independent scrutiny. Readers receive the conclusion without the clinical reasoning necessary to evaluate it.


Could the fatal blood clot have been connected to her earlier illness?

There are two possibilities worth examining, and they point in opposite directions.

The first is that an underlying medical disorder might have contributed to both neurological symptoms and thromboembolic disease. Pulmonary embolism can be an isolated event, but some patients experience recurrent thrombosis or have conditions that increase their tendency to develop blood clots in different parts of the body.

For example, antiphospholipid syndrome (APS) is an autoimmune disorder associated with an increased risk of thrombosis. It can cause deep vein thrombosis, pulmonary embolism and stroke, with seizures among its recognized neurological associations.

Another relevant condition is cerebral venous thrombosis (CVT), in which blood clots obstruct veins draining the brain. Depending on the location and extent of the thrombosis, symptoms can include seizures, headaches, visual disturbances, weakness, sensory abnormalities and altered consciousness. Arterial thromboembolic events can also cause neurological deficits, while rare paradoxical emboli can carry clots from the venous circulation into arteries supplying the brain.

Chronic pulmonary thromboembolic disease itself would not ordinarily explain years of widespread numbness and recurrent seizures. The more relevant hypothetical connection would be an underlying vascular or clotting disorder affecting multiple systems.

There is no published evidence that Allison had APS, cerebral venous thrombosis, previous strokes or recurrent emboli. These are medically recognized differential considerations, not retrospective diagnoses. Without imaging, laboratory findings and her clinical records, attributing her neurological symptoms to any of them would be speculation.

The second possibility is more straightforward: could her severe disability have contributed to the blood clot that killed her?

Allison reportedly needed assistance with basic activities and experienced repeated hospital admissions. If her mobility was substantially restricted, particularly during prolonged periods of illness or hospitalization, that could have increased her risk of deep vein thrombosis and pulmonary embolism.

Immobility and hospitalization are established risk factors for venous thromboembolism. The CDC identifies restricted movement as a risk factor, while NICE guideline NG89 addresses thromboembolism risk assessment and prevention in hospitalized patients.

We do not know Allison's level of mobility before her final admission, whether thromboprophylaxis was indicated or provided, or whether her pulmonary embolism was preventable. But the general principle is important: the physical consequences of disability do not become less real because the disability has been attributed to FND. A diagnostic label does not protect someone from the complications of immobility.

There is also an unusual reference in the reporting to Allison's condition being like not having a functioning immune system. She experienced repeated hospital admissions and was admitted with an infection shortly before her death. FND is not an immune deficiency disorder, although the description does not establish that she had a diagnosed immune-system abnormality. Infection, inflammation and hospitalization can themselves influence thromboembolic risk. Whether any of those factors contributed to her death remains unknown.


Premature diagnostic closure: when the label becomes the answer

Premature diagnostic closure occurs when clinicians settle on an explanation before the available evidence adequately supports it, potentially overlooking alternatives or failing to reconsider their conclusions when new information emerges. It is a recognized diagnostic reasoning problem, often associated with anchoring bias.

We cannot establish that premature closure occurred in Allison's care. The published account is not a medical record, and it would be irresponsible to present her death as proof of misdiagnosis or negligence.

But her story raises the broader issue with uncomfortable clarity. What happens when a patient has already received a diagnosis and subsequently develops new symptoms, worsening disability or serious medical complications? Are those developments evaluated independently, or are they interpreted through the diagnosis already attached to the patient?

The danger is not simply getting the original diagnosis wrong. It is allowing that diagnosis to influence every subsequent clinical judgment. New symptoms can be attributed to an established condition without sufficient investigation. Coexisting diseases may receive less attention. Deterioration can become something to explain away rather than something to reassess.

Having FND does not prevent someone from developing epilepsy, autoimmune disease, vascular disease, infection or cancer. It does not establish that every symptom belongs to the same disorder. Even a correctly established diagnosis must remain open to reconsideration when new evidence warrants it.

A diagnosis is a clinical conclusion, not a lifetime contract.

In Allison's case, the reporting leaves several important questions unanswered:

  • Which positive neurological signs supported the original FND diagnosis?
  • How were her seizures and widespread sensory disturbances investigated?
  • Was there evidence of an underlying vascular, autoimmune or clotting disorder?
  • How restricted was her mobility, and was her thromboembolic risk appropriately assessed during hospitalization?
  • Did the investigation into her fatal pulmonary embolism identify any contributing or potentially preventable factors?

None of these questions establishes that something was missed. But they illustrate the difference between knowing that a diagnosis was made and knowing whether the evidence adequately supported it.


You do not owe a diagnosis anything

The point of this article is not to suggest that everyone diagnosed with FND should suspect an undiscovered clotting disorder. Nor is it to claim that Allison's death was caused by a diagnostic mistake. The evidence does not support either conclusion.

The point is that patients should never be expected to protect a diagnosis at the expense of their own health.

You are not responsible for defending FND, preserving a clinician's reputation or proving that a previous medical conclusion was correct. You have every right to ask what evidence supports your diagnosis, seek a second opinion, question explanations that fail to account for your symptoms and request further assessment when clinically warranted.

That does not mean rejecting every diagnosis or demanding endless investigations. It means recognizing that medical conclusions must remain accountable to evidence, including evidence that emerges after the original diagnosis was made.

Allison Lawlor's story cannot tell us whether her neurological symptoms and fatal pulmonary embolism were connected, or whether a different medical decision could have changed her outcome. It can, however, remind us why diagnostic vigilance matters and why severe disability must never be reduced to a label.

Your health is not a referendum on the validity of FND. Your survival is not an exercise in diagnostic loyalty.

If something changes, if your condition deteriorates or if important findings remain unexplained, you are entitled to keep asking questions. The purpose of a diagnosis is to help explain and manage your condition, not to demand your allegiance.

This is your life. You do not owe a diagnosis anything. Not your loyalty. Not your silence. And certainly not your life.

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