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Thought Crawlers

These parasitic worms live in cerebrospinal fluid. Their microscopic eggs can be carried on the wind or coated on a weapon, and enter the body though exposed nerves, such as those in injured skin. Once in the body, the worms travel along the nervous system to the brain and spine, causing an escalating progression of debilitating neurological symptoms.

Type infestation, injury; Save Fortitude DC 16; Onset 1 day; Frequency 1/day


1d2 Intelligence and 1d2 Wisdom damage; see below


3 consecutive saves


Apply the effects below based on the cumulative Intelligence or Wisdom damage the victim has sustained from the disease (less any amount cured), using the higher total. The effects are cumulative. Save DCs equal the disease's save DC.

2–6 points: The victim is highly suggestible. Treat any request as though delivered by suggestion (Will DC negates).

7–12 points: The victim becomes irritable and aggressive. If provoked or insulted, the victim attacks for 1 round (Will negates). If attacked, even in self-defense, the victim automatically responds in kind for 1 round (no save). Severe headaches leave the victim distracted when casting spells (Concentration DC 10 + the level of the spell the victim is casting).

13+ points: Severe headaches leave the victim sickened. Each round when under stress (such as during combat), the victim must succeed at a Fortitude saving throw or be nauseated until the start of its next turn.