Steven Novella on the Causeway Killer Mystery

The tragic assault of a homeless man and the death of his attacker on May 26 in Miami FL has received much press coverage. No doubt is was an extreme case and must be approached cautiously. Some were quick to make light of it and other even appeared to genuinely fear a zombie apocalypse. The CDC was even consulted and responded, “CDC does not know of a virus or condition that would reanimate the dead (or one that would present zombie-like symptoms)”. Other news outlets were quick to blame “bath salts” (Methylenedioxypyrovalerone), but now the release of the offical toxicology report contradicts this assumption. The only drug detect in Rudy’s body was cannabis. Steven Novella writes in a post titled Causeway Killer Mystery on his blog about the case,

I wrote previously about the case of Rudy Eugene, the “Causeway Cannibal” who was found by police naked chewing on the face of a homeless man. At the time I felt the most plausible hypothesis for this bizarre and violent behavior was drugs, especially given that Eugene had no history of violence. It was therefore a little surprising when the official toxicology report came out Wednesday showing only marijuana in Eugene’s system, and no other known street or prescription pscyoactive drugs – no LSD, bath salts, cocaine, narcotics, benzodiazepines, or barbiturates.

So what are we to make of this? We now have a neuropsychiatric mystery – what can cause a man with no history of violence to do what Eugene did. According to reports he parked his car on the beach, then walked back to Miami, stripping off his clothes along the way. He had his bible with him and he tore out pages leaving them along the road as well. At one point he was seen swinging naked from a light post. He then came upon Ronald Poppo, subdued him, tore off his clothes, and then proceeded to chew off his face (but not swallow the tissue). When confronted by an armed police officer Eugene refused to stop his behavior and was then shot four times until he was dead.

If we treat this as a medical history, then what is our differential diagnosis?…

You can read the full post on NeuroLogica Blog.

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