You experience seizures. Choose or roll on the following table. If you remain aware and conscious during a seizure, you must succeed on a DC 8 + (IE) Constitution check to maintain concentration if needed.

function generateSeizure() { const rand = Math.floor(Math.random() * 100) + 1; let seizureType;

if (rand <= 40) { seizureType = "Focal Aware Seizures"; } else if (rand <= 60) { seizureType = "Focal Impaired Awareness Seizures"; } else if (rand <= 67) { seizureType = "Absence Seizures"; } else if (rand <= 77) { seizureType = "Myoclonic Seizures"; } else if (rand <= 82) { seizureType = "Clonic Seizures"; } else if (rand <= 88) { seizureType = "Tonic Seizures"; } else if (rand <= 93) { seizureType = "Atonic Seizures"; } else { seizureType = "Tonic Clonic Seizures"; } document.getElementById("seizureType").innerHTML = "Seizure Type: " + seizureType; }

• Focal Aware Seizures. You have a strange feeling for (IE)d20 seconds resulting in one of the following experiences.
  

  d8	Experience
  1	Nausea
  2	Unusual smell or taste: You smell or taste something with no known source. You have a −(IE) penalty on all Wisdom (Perception) checks related to smell and taste for the duration.
  3	Amplified Emotion (both kinds equally likely)
  4	Myoclonic Seizure in one random arm
  5	Numbness in one random limb
  6	Feeling like one random limb is larger or smaller than it actually is: you have a −(IE) penalty on all Dexterity attack rolls, ability checks, and saving throws with that limb for the duration.
  7	Perception of colored or flashing lights: You have a −(IE) penalty on all Wisdom (Perception) checks involving vision
  8	Hallucinations

• Focal Impaired Awareness Seizures. You become confused as if under the Confusion spell for (IE)d4 minutes.
• Absence Seizures. You become stunned and unaware of your surroundings for (IE)d4 seconds. You may carry on simple actions like walking, but you are unconscious as far as your mind and senses go.
• Myoclonic Seizures. Your muscles jerk (IE)d4 times, once every round. You have a −(IE) penalty on all Strength or Dexterity attack rolls, ability checks, and saving throws during a seizure and must succeed on a DC 5 + (IE) Dexterity saving throw or drop anything you’re holding in your hands. Any spell that you attempt to cast with a somatic component will fail but will not use your spell slot.
• Clonic Seizures. Your muscles have spasms that make your face, neck, and arm muscles jerk rhythmically. During this seizure, you have a −(IE × 2) penalty on all actions requiring the use of your arms and cannot cast spells requiring a somatic component. Casting a spell with a verbal component requires a successful DC 10 + (IE) Constitution check. Failure results in the spell failing, but it does not use a spell slot. Clonic Seizures last (IE)d6 rounds.
• Tonic Seizures. The muscles in your arms, legs, or trunk tense up. When this seizure begins, you must succeed on a DC 10 + (IE) Dexterity saving throw or become prone. On success, you must continue this check each round for the duration of the seizure. Your movement during the seizure is divided by the IE. Tonic Seizures last (IE)d4 rounds.
• Atonic Seizures. Your muscles suddenly become paralyzed, and you become prone. You must succeed on a DC 10 + (IE) Wisdom (Perception) saving throw to notice the onset of the seizure and to use an action to intentionally become prone. Failure results in falling and taking 2 (1d4) bludgeoning damage unless wearing a helmet. The seizure lasts (IE)d4 seconds, but you get (IE)d4 of them in a row with 1d4 rounds in between each of them.
• Tonic Clonic Seizures. Your body stiffens, jerks, and shakes, and you become unconscious. Sometimes you lose control of your bladder or bowels. This seizure lasts 1d(IE) × 2 minutes.

Real-world Examples

Epilepsy, Gray Matter Heterotopia, Traumatic Brain Injury, Lupus, Multiple Sclerosis

Assistive Options

Those with seizures benefit from someone watching them for the onset. A friend or ally nearby at the onset can use their action to help you, giving you advantage on checks against falling, bumping into something harmful, and other physical effects. You may also consult the section on Service Animals.

You experience pain differently than most people. Choose or roll on the following table.

One thing I want others to understand about my experience with depression and chronic pain is that while I’m capable of doing most things that someone without my disabilities can do, the cost of my efforts on my energy levels and body are much greater than the other person. For example, walking three blocks feels like I walked a mile and a minor bump into a doorway feels like I was hit by a metal baseball bat.

– Heather Thomas

• Chronic Pain. You experience chronic pain throughout your body. Any action that requires concentration (e.g., maintaining a spell) requires a successful DC 10 + (IE) Constitution saving throw per round to maintain concentration. Because you’re used to managing pain, even though this doesn’t reduce the experience of pain, you have a +(IE) bonus to saving throws against psychic damage.
• Hyperalgesia. You experience pain more intensely than most people. When you take physical damage, you also take (IE) × 5 percent psychic damage (minimum 1). Any rolls to maintain concentration also have a −(IE) penalty when taking damage. Because you’re used to managing pain, even though this doesn’t reduce the experience of pain, you have a +(IE) bonus to saving throws against psychic damage.
• Hypoalgesia. You experience less pain from injury than most people. On any day spent on at least mild activity, you must succeed on a DC 8 + (IE) Dexterity saving throw. On failure, you sustain a sore or wound that you’re unaware of. You must then succeed on a DC 8 + (IE) Wisdom (Perception) check to identify the wound so it can be treated. If you receive help on this check, you make the roll with advantage. If identified, a successful DC 5 + (IE) Wisdom (Medicine) check will allow the wound to heal. If the check fails, you sustain 1d(IE) damage per day until successfully treated. Because you do not feel pain the way most people do, you have resistance to psychic damage.

Real-world Examples

Anxiety, Neuropathy, Diabetes, Hereditary Sensory and Autonomic Neuropathy, Muscle Spasticity, Fibromyalgia, Myofascial Pain Syndrome, Polymyalgia Rheumatica

Assistive Options

Pain can be managed by avoiding the stimulus that triggers it or limiting physical exertion. Depending on the location and nature of the pain, using a cane, walker, or support hose can reduce the IE by 1. Relaxation techniques can reduce pain levels. If a short rest is used for a relaxation and stretching technique, the IE is reduced by 1 for 1d4 hours. Alternately, receiving a 1-hour massage will reduce the IE by 1 for 1 day. Hypoalgesia depends heavily on friends and allies helping to watch for wounds or irregularities as noted in the description.

You have trouble remembering events. Choose or roll on the following table.

• Anterograde Amnesia. You are unable to form new memories but recall your past until 1d100 × 30 days ago or after a specific story arc. Recalling new events, people, directions, or other details requires a successful DC 8 + (IE) × 2 check to remember general information or a higher DC for specific details. You can still sometimes learn procedures and routines. All Experience Points you earn are divided by (IE) + 1 or, if not using XP level advancement, when gaining or increasing a feat or proficiency, you need an additional (IE)d20 days to gain the bonus. It also takes you (IE) × 5 times as long to prepare spells. This form of memory loss has no Frequency. When charmed, you get an extra saving throw each round as you may forget your favorable impression of the source of the charm.
• Retrograde Amnesia. You have difficulty recalling memories before 1d100 × 30 days ago or before a specific story arc but have full memory of everything after that. You retain general knowledge and skills but may not remember how you learned. You’re more likely to remember episodes from your distant past than more recent memories. Recalling people or events from the most recent (IE) × 20 percent of your life requires a successful DC 10 + (IE) × 2 Intelligence check, and recalling earlier memories requires a successful DC 10 + (IE) Intelligence check. A successful check will recall general information, more details requiring a higher DC. This form of memory loss has no Frequency.

Sometimes life feels like a constant brain fog. But times spent sitting with friends telling stories are the golden moments of clarity I live for.

-Niles M

• Dissociative Fugue. You are confused about your identity or have formed a new one. You retain skills from your original identity but may try using skills you don’t have. For example, you may experience frustration as to why you can’t cast spells or why you can, believe your stealth skills are better than they are, etc. The GM and player should work together on the false identity, creating a random persona but retaining most or all previous abilities. (Try a random NPC or character class generator such as the one on dndbeyond.com or npcgenerator.com to get started.) This form of memory loss does have a Frequency, and recalling a single memory about your identity requires a successful DC 10 + (IE) × 2 Intelligence check while in a fugue state.
• Traumatic Amnesia. You have little or no memory of (IE) traumatic events from your past. Recalling a detail from one of those events requires a successful DC 15 + (IE) Intelligence check. Failure requires (IE) × 30 days or until after the next adventure or story arc for each event before making another attempt. When successfully recalling a traumatic memory, you may feel overcome while you come to terms with this recovered memory and must succeed on a DC 8 + (IE) Wisdom saving throw or take one level of exhaustion for 10 × (IE) minutes. This form of memory loss has no Frequency.

Real-world Examples

Korsakoff’s Syndrome, Dementia, Post-Traumatic Stress Disorder, Dissociative Amnesia, Encephalitis

Assistive Options

Written notes or journals can help keep track of memories. Friends and allies can help with recall, granting advantage on recall attempts even if the helper was not present for the episode in question.

Magical Assistance

Divination spells like Divination and Commune can help answer questions about the past that have been forgotten, but it does not recover the actual memory.

You have trouble communicating using language, including speaking, understanding, and writing. Choose or roll on the following table. You have 1d6 of the following patterns.

• Dysgraphia. Your writing appears haphazard, with irregular spelling and spacing, such as missing spaces between words and spaces in the middle of words. Anyone attempting to read your writing must succeed on a DC 8 + (IE) Wisdom (Perception) check. You can write conventionally with extreme effort, requiring you to concentrate by making a DC 10 + (IE) Constitution check per sentence, adding (IE) cumulatively per sentence but also adding (IE) to any quality-related checks due to the additional scrutiny. Any conventional writing after that requires a short rest. Transcribing spells into your spellbook takes (IE) × 10 times as long as usual.
• Reiterative Agraphia. When you write, you tend to repeat words and letters, making your writing difficult to read. Anyone attempting to read your writing must succeed on a DC 8 + (IE) Wisdom (Perception) check. You can write conventionally with extreme effort, requiring you to concentrate by making a DC 10 + (IE) Constitution check per sentence, adding (IE) cumulatively per sentence but also adding (IE) to any quality-related checks due to the additional scrutiny. Any conventional writing after that requires a short rest. Transcribing spells into your spellbook takes (IE) × 10 times as long as usual.
• Specialist Agraphia. You are unable to write in a specific format tied to your class/profession, such as writing spells, musical notation, alchemical formulae, written Thieves’ Cant, etc. You can write conventionally with extreme effort, requiring you to concentrate by making a DC 10 + (IE) Constitution check per sentence, adding (IE) cumulatively per sentence but also adding (IE) to any quality-related checks due to the additional scrutiny. You cannot inscribe spells into your spellbook and must find or hire someone of your level or higher to assist you in doing so. The typical fee of this task is 25 gp × (spell level), but the scribe will often do so in exchange for the option to make a copy of the spell for themselves if they don’t already have it.
• Dysexecutive Agraphia. You have trouble organizing your thoughts, so your writing includes sentences out of order or words out of order in sentences, like a verbal jigsaw puzzle. You cannot write any kind of ordered directions unless taking dictation. You can write conventionally with extreme effort, requiring you to concentrate by making a DC 10 + (IE) Constitution check per sentence, adding (IE) cumulatively per sentence but also adding (IE) to any quality-related checks due to the additional scrutiny. Anyone attempting to read your writing must succeed on a DC 8 + (IE) Wisdom (Perception) check. Transcribing spells into your spellbook takes (IE) × 5 times as long as usual.
• Apraxic Agraphia. You can read and speak, but you can’t write in any meaningful form. You cannot inscribe spells into your spellbook and must find or hire someone of your level or higher to assist you in doing so. The typical fee of this task is 25 gp × (spell level), but the scribe will often do so in exchange for the option to make a copy of the spell for themselves if they don’t already have it.
• Lexical Agraphia. You can only spell & read phonetically. Irregularly spelled words are like an unknown language to you. Anyone attempting to read your writing must succeed on a DC 5 + (IE) Wisdom (Perception) check. When you try to read something, you must succeed on a DC 8 + (IE) Wisdom (Perception) check to get the gist of the writing, and you cannot use spell scrolls. Transcribing spells into your spellbook takes (IE) × 5 times as long as usual and the assistance of a caster able to cast that spell. The typical fee of this task is 25 gp × (spell level), but the scribe will often do so in exchange for the option to make a copy of the spell for themselves if they don’t already have it.
• Semantic Agraphia. When you write, you tend to substitute related (but not synonymous) words, so when you want to write, “pirate,” you instead write, “ship” or “sea.” You can write conventionally with extreme effort, requiring you to concentrate by making a DC 10 + (IE) Constitution check per sentence, adding (IE) cumulatively per sentence but also adding (IE) to any quality-related checks due to the additional scrutiny. Any conventional writing after that requires a short rest. Transcribing spells into your spellbook takes (IE) × 10 times as long as usual.
• Phonological Agraphia. You cannot sound out words to read them, relying only on recognition of words whose spellings you’ve memorized. This memorization is closely tied to your senses, so you especially have trouble reading abstract words. Reading requires a successful DC 8 + (IE) Wisdom (Perception) check to read about a concrete object with a higher DC, or depending how abstract the content is, a spell scroll having a DC 15 + (IE) + (spell level). It takes you (IE) + 1 times as long to prepare a spell. Transcribing spells into your spellbook takes (IE) × 5 times as long as usual and the assistance of a caster able to cast that spell. The typical fee of this task is 25 gp × (spell level), but the scribe will often do so in exchange for the option to make a copy of the spell for themselves if they don’t already have it.
• Visuospatial Agraphia. Your writing takes irregular spacing and forms. It may not be in a straight line, or it may only be in a corner of the page, words and letters overlapping, duplicate lines when writing letters, etc. Anyone attempting to read your writing must succeed on a DC 8 + (IE) Wisdom (Perception) check. Transcribing spells into your spellbook takes (IE) × 5 times as long as usual and the assistance of a caster able to cast that spell. The typical fee of this task is 25 gp × (spell level), but the scribe will often do so in exchange for the option to make a copy of the spell for themselves if they don’t already have it.
• Alexia. You can spell and write, but you can’t read, even something you just wrote, unless you succeed on a DC 15 + (IE) Wisdom check per sentence. You cannot use spell scrolls, and to prepare a spell, you need someone of your class who is high enough level to cast the spell who must read the spell to you from your spellbook and help you prepare it. The reader may prepare the spell for themselves at the same time. Because you’ve learned to write without reading or editing what you write, you can transcribe spells into your spellbook in half the usual time, but you must succeed on a DC 8 + (IE) check of your casting stat to accurately transcribe the spell unless you have help.
• Expressive Aphasia. You can understand language but have trouble speaking, uttering short phrases at best. To speak, you must succeed on a successful DC 8 + (IE) Constitution check for each phrase. You cannot use spell scrolls, and spells with a verbal component require you to modify them to add additional somatic components if possible. The complexity of this change requires one day for every hour usually needed to inscribe it into your spellbook and twice the cost due to additional experimentation needed. Communication via writing can be done without penalties.
• Receptive You can speak, but your sentences are incoherent and contain unnecessary words. However, you don’t realize others have trouble understanding you, and you have trouble understanding spoken language. For your speaking to be understood, the listener must succeed on a DC 8 + (IE) Wisdom (Perception) check, and you must do the same to understand the gist of anything said to you. You cannot use spell scrolls, and spells with a verbal component require you to modify them to add additional somatic components if possible to avoid needing verbal components. The complexity of this change requires one day for every hour usually needed to inscribe it into your spellbook and twice the cost due to additional experimentation needed. Communication via writing can be done without such penalties.
• Anomic Aphasia. You have trouble finding the right words for what you want to talk about, both in speech and writing, so you have to use other words instead, which may seem vague. You have a −(IE) penalty on Charisma (Persuasion) checks, but because you’re used to manipulating language to express yourself, you have a +(IE) bonus to verbal and written Charisma (Deception) checks.
• Global Aphasia. You can speak and understand very little spoken language. To understand or communicate information in a verbal conversation, you must succeed on a DC 12 + (IE) Intelligence saving throw to determine whether your brain allows you to form and process enough applicable words.

Real-world Examples

Aphasia, Agraphia, Dysgraphia, Alexia, Gerstmann Syndrome, Parkinson’s Disease, Tourette Syndrome

Assistive Options

Spending a short rest preparing for a known upcoming situation or other language need will reduce the IE by 1 (to a minimum of 1) for 1d4 hours. Aphasia does not affect sign language, so you can use signs or written language as alternatives.

You excel in one specific subject (e.g., insects, dragons, trees, knots, building construction, etc.) and have a +(IE) bonus to specific ability checks regarding that subject. The subject must be specific to receive this bonus: a family of organisms, a species of humanoids (e.g., goblins, not goblinoids, although a GM could give a partial bonus for goblinoids), a weapon, a specific famous person, etc. at the GM’s discretion. The more specific the subject, the broader the amount of related ability checks receive that bonus, so fixating on dragons may give you skills on Intelligence checks related to dragons, but fixating on dragon lairs may help you navigate the lairs more effectively, giving you bonuses against lair actions and against surprise while in the lair. Fixating on swords may give you bonuses to Intelligence checks regarding a sword’s construction, age, and culture of origin, but a topic as specific as goblin rapier maneuvers may give you a bonus in melee combat against goblins who are fighting with rapiers. The player and GM should work together to determine guidelines that will depict the experience without unbalancing the game, and note that the bonuses are usually related to Intelligence or Wisdom-based ability checks.

At the same time, because you enjoy this topic so thoroughly, you may have difficulty focusing on other topics or may be tempted to change uninteresting conversation topics to the subject of your Interest. When in a social setting, you must succeed on a DC 8 + (IE) Charisma saving throw to avoid attempting to change the topic of a conversation. If you encounter a lot of rejection, you may develop Secondary Depression.

Between every adventure or major campaign arc, you must roll 1d20. On a 1, your Interest changes to a different topic that may be related or have nothing to do with the previous one and may likely be related to a detail from the recent adventure. You retain a half IE bonus on previous interests.

If you have multiple traits, you may choose Social Interaction Difference, Insomnia, Sleep-Wake Disruption (Delayed Phase), or Attention Difference as one or more of them.

Real-world Examples

Autism, Attention Deficit Hyperactivity Disorder

Assistive Options

Finding others who share your interests can help you feel safe and accepted, and allies who ask you about your interest and allow you to infodump to them can help your sense of well-being.

You experience frequent fevers, causing 1 level of exhaustion. During the Frequency, the GM should roll a passive Constitution check (IE) times per day at random intervals to determine whether another fever episode is beginning. Once it begins, you must succeed on a DC 10 + (IE) Constitution saving throw to recover. On a failed saving throw, you must take a long rest before making another saving throw. If the number rolled is a natural (IE) or less, you gain another level of exhaustion. You can make another saving throw after each long rest to remove one level of exhaustion.

Real-world Examples

Periodic Fever Syndrome

Assistive Options

Another character may assist with your Constitution saving throw with a successful Wisdom (Medicine) saving throw, the DC equal to the required Constitution saving throw. On success, the help gives the fevered character advantage on the next Constitution saving throw. If you spend an entire day resting and drinking twice the amount of water you usually require, you get +2 bonus on the next Constitution saving throw.

You are nearly always tired. After every long rest, you must succeed on a DC 8 + (IE) Constitution saving throw, or you do not benefit from the rest, regardless of the amount of rest you get. Spending an entire day resting will automatically give you advantage on the Constitution saving throw.

Real-world Examples

Chronic Fatigue Syndrome, Lyme Disease, Fibromyalgia, Lupus, Hypothyroidism, Multiple Sclerosis, Insomnia, Postural Orthostatic Tachycardia Syndrome

Assistive Options

Beginning a long rest three days in a row at roughly the same time grants a +1 bonus to the Constitution saving throws, keeping the pattern adding an additional +1 bonus cumulatively to a maximum of +5. Keeping a diet for at least seven days of fish, vegetables, and nuts gives a +1 bonus to the Constitution saving throw. Drinking more alcohol than (Constitution Bonus) drinks will negate this bonus. A weighted blanket during a short rest also gives a +1 bonus to the Constitution saving throw. Such a blanket can be made from two large animal pelts for a medium humanoid or two medium animal pelts for a small humanoid plus enough sand to make the total weight 10 percent of your body weight. The cost of fabrication is 20 gp.

Magical Assistance

If the fatigue is caused by Insomnia, a Sleep spell or other effect that mimics it will assist in getting to sleep during a long rest and will reduce the IE by 1 Extent until the next long rest.

You have a tendency to frequently become unconscious. You become lightheaded for a round, causing disadvantage on all rolls. During this round, you must succeed on a DC 8 + (IE) Wisdom saving throw (without disadvantage) to intentionally become prone. Failure indicates that you didn’t notice in time and take 1d2 bludgeoning damage from falling over. The next round, you must succeed on a DC 10 + (IE) × 2 Constitution saving throw (without disadvantage) to remain conscious, rolling with advantage if prone. On success, you remain lightheaded the rest of the round. On a failed roll, you become unconscious for (IE)d4 minutes. During the Frequency, the GM should roll a passive Constitution check (IE) times per hour at random intervals to determine whether another fainting episode is beginning. If the Frequency is Triggered, some common triggers include standing up quickly or for too long in one place, Pain, and Dehydration.

Real-world Examples

Hypoglycemia, Anemia, Dysautonomia, Amyloidosis, Heart Arrhythmia

Assistive Options

Quickly applying a cold solid or liquid to the face gives advantage on the Constitution check to remain conscious. Being in a cold environment does not have the same effect, as it’s the sudden temperature change that helps.

You experience mental fatigue that affects your memory, ability to concentrate and think clearly, and focus. You have a −(IE) penalty on concentration saving throws, and when you need to make an Intelligence check to remember something, you have a −(IE) penalty on the check unless you take 1 + (IE) times as long to think about it.

Real-world Examples

Autism, Attention Deficit Hyperactivity Disorder, Chronic Stress, Sleep Disorders, Menopause, Anemia, Depression, Diabetes, Sjögren Syndrome, Migraine, Dementia, Hypothyroidism, Lupus, Arthritis, Multiple Sclerosis, Dehydration, COVID-19

Assistive Options

Regular sleep and exercise and a balanced diet may help. A rest will relieve Brain Fog for 1d6 hours. Keeping a journal, calendar, task list, or other notes can compensate for memory challenges.

You are unable to recognize, use, and feel: one side of your body (75 percent left, 25 percent right); your arm (IE 1); your arm and leg (IE 2); your arm, leg, and face (IE 3); or your entire side (IE 4). Even seeing that these parts of you are connected, you cannot recognize them as part of you unless someone trusted is trying to demonstrate the fact, and you succeed on a DC 10 + (IE) × 2 Wisdom saving throw, and even then, only for 1d4 minutes. You cannot explain the presence of that body part, only that it’s not yours, but you also don’t typically notice that it’s there. In 25 percent of cases, you believe that the body part belongs to someone else, typically a close family member or significant other. The dissociated body parts are treated as paralyzed with associated effects, but you also feel no need to protect or take care of that part of your body.

Real-world Examples

Asomatognosia, Somatoparaphrenia, Unilateral Neglect

Assistive Options

A high-quality silver mirror will give a +1 bonus to Wisdom saving throws to recognize the body part. Irrigating the dissociated ear with cool water for a minute for IE 3–4 will give a +2 bonus to the Wisdom saving throw.