You experience chronic pain in your ears, causing ear pain and headaches. 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.

Real-world Examples

Otitis Media, Otitis Externa, Eustachian Tube Dysfunction, Wegener Granulomatosis, Ramsay Hunt Syndrome, Polychondritis

Assistive Options

Applied heat or cold may help, as can sleeping upright in some circumstances. A character with chronic ear pain will likely have determined what works for them. The player and GM should decide what works effectively, and using this method will reduce the IE by 1 for 1d6 hours.

Magical Assistance

Any kind of magical healing, except potions, that relieves at least 1 hp can be applied directly to the ears to reduce pain by 2 IEs for a number of hours equal to the number of hp that would’ve been healed to a maximum of 1 day.

Some of your face is paralyzed (20 percent × IE), making it difficult to talk and use non-verbal communication with your face. You receive a penalty on Charisma (Performance) and Charisma (Persuasion) checks equal to the IE. This is typically permanent, but the player and GM could choose a magical cause that results in fluctuations.

Real-world Examples

Bell’s Palsy, Lyme Disease, Injury, Multiple Sclerosis, Ramsay-Hunt Syndrome, Guillain-Barré Syndrome, Moebius Syndrome, Melkersson-Rosenthal Syndrome, Stroke

Assistive Options

Because facial paralysis usually prevents the eye from blinking fully, you must use eye drops to keep the eye moist and likely need to monitor for drooling and keep a towel handy.