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Not every mind is strong enough to withstand the curse of Malkav and still function (in a fashion). The Gnawed are those Malkavians that have been deemed nonfunctional through the madness transferred through the Embrace. Most are catatonic or howling idiots, unable to function in Kindred society.
Most Gnawed are locked away, rumored to be used as feeding stock for Malkavian elders.