Epilepsy Mechanics
The following is are epilepsy mechanics for 5th Edition for Dungeon and Dragons
By Isaac Cooke-Khan
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Epilepsy
Epilepsy is a condition that affects the brain. When someone has epilepsy, it means they tend to have epileptic seizures. Anyone can have a one-off seizure, but this doesn’t always mean they have epilepsy. Epilepsy is usually only diagnosed if a doctor thinks there’s a high chance that the person could have more seizures.
Electrical activity is always happening in the brain, this is the cells in the brain sending messages to each other and controlling the body.
A seizure happens when there is a sudden burst of powerful electrical activity in the brain which causes a temporary interruption to the way the brain usually works, so the brain’s messages become disoriented. The result is an epileptic seizure.
There are different types of seizures. What happens during a seizure depends on which part of the brain is affected, and how the seizure spreads.
Many different factors can cause someone to develop epilepsy a few examples being genetic factors, previous injury or sickness etc.
The most prominent treatment for epilepsy is medication. These are sometimes called anti-epileptic drugs or AEDs. The medicine doesn’t cure epilepsy but helps to stop or reduce the number of seizures.
Seizure triggers
Some things make seizures more likely for some people with epilepsy. These are often called ‘triggers’. Triggers don’t cause epilepsy, but they make seizures more likely. Not all people with epilepsy have seizure triggers and what are triggers for one person’s seizures might not affect other people with epilepsy in the same way. There are common triggers that can occur such as excessive drinking, missing meals, tiredness, extreme weather etc but your character can also have more specific triggers.
When designing your character you can select triggers with your DM, or you can roll for triggers.
If rolling, roll a D4, this will be the number of triggers your character will have. Afterwards, roll on the previous amount on the following table to determine your triggers:
Seizure triggers
| Dice Roll | Seizure triggers |
|---|---|
| 1 | When there are sudden, flashing or flickering light sources |
| 2 | When you or someone within 10ft you take Psychic damage |
| 3 | When a transmutation spell is cast within 15ft of you |
| 4 | When drinking a healing potion |
| 5 | Attuning/Unattuning to a magical item |
| 6 | When you are teleported |
| 7 | When you take Necrotic damage |
| 8 | When you are feared |
| 9 | If you gain a magical fly speed |
| 10 | When a spell with a casting time of a reaction is used with 30ft of you |
| 11 | When you become poisoned |
| 12 | When you take the dash action |
| 13 | Gaining a level of exhaustion |
| 14 | Extreme temperatures (heat, cold etc) |
| 15 | Viewing illusion magic |
| 16 | Becoming unconscious |
| 17 | Taking more than half your maximum HP in damage in one round |
| 18 | When failing any saving throw by 1 |
| 19 | When a thunder damage type spell is cast within 30ft of you |
| 20 | Taking fall damage |
When a trigger occurs, you must make a Contusion saving throw of DC11, a failure resulting in a Seizure. Regardless of passing or failing the check, the DC is increased by 2 after each occurrence of a trigger.
There are different Seizure types, discuss with your DM what type your character will have or with their permission, roll on the following table:
Seizure type
| Dice Roll | Seizure type |
|---|---|
| Focal Onset | |
| :----: | |
| 1 | Focal seizures, retains awareness, stunned for 1d4 rounds |
| 2 | Focal seizures, impaired awareness, stunned for 1d4 rounds |
| Generalised onset | |
| :----: | |
| 3 | Myoclonic, retains awareness, drops any item being carried |
| 4 | Tonic, impaired awareness, becomes prone |
| 5 | Atonic, impaired awareness, becomes prone |
| 6 | Clonic, 1d4 subtracted from the next melee attack or melee spell roll until the end of your next turn |
| 7 | Absence, impaired awareness, stunned until the end of your next turn |
| 8 | Myoclonic, awareness varies, 1d4 subtracted from the next saving throw made until the end of your next turn |
Proficiencies & Advantages
Characters with Epilepsy gain the following:
After learning about your illness and being able to read your own body well you gain proficiency in Medicine and Insight skills.
Service familiar: You learn the find familiar spell that you can cast as a ritual. The familiar can be used as a normal familiar but can also benefit someone with epilepsy in the following ways:
- Make noise or otherwise alert others when a character has a seizure while alone
- Lie next to someone having a seizure to prevent injury
- Place their body between the seizing individual and the floor to break the fall at the start of a seizure.
- Activate some kind of pre-programmed devices, such as a pedal that rings an alarm.
Epilepsy auras
An 'aura' is the term that some people use to describe the warning they feel before they have a seizure.
Focal aware seizures (FAS) are sometimes called ‘warnings’ or ‘auras’ because, for some people, a FAS develops into another type of seizure. They can vary in many ways such as:
- Getting an unusual smell or taste
- A sudden intense emotion such as joy or fear
- Visual disruption such as flashing lights or hallucinations
- A feeling of numbness or tingling all over or parts of the body
An aura state can happen when around triggers e.g. starting the attunement process of a magic item or the beginning of a certain spell. To determine the length of the aura state role 1d8 if even the aura state lasts minutes if odd the aura state last hours. After roll 1d4 to determine the number of minutes or hours the aura state will last.
The aura state can be disorientating so the following effects apply when in an aura state:
- Skill checks made that you have proficiency in subtracting 1d4 from the total, skill checks without proficiency subtract 1d6 from the total.
- Any Charisma, intelligence or wisdom saving throws you make are done with advantage.
Magic and treatment
While magic and healing spells exist for some temporary injures, epilepsy caused by physical trauma they will be high level and expensive. And those who are born with Epilepsy is not something that magic can “fix” as that is how they were born.
Medication is available known as Anti-epileptic drugs which can reduce the frequency of seizures, lowering the DC by 1 per drug taken but not below DC11.
- 1 pill can be taken safely per long rest
- 2 pills can be taken but a DC15 constitution check must be made or receive the poisoned condition
- 3 pills can be taken but a DC18 constitution check must be made or receive the poisoned condition and a level of exhaustion is taken regardless of the save outcome
- More than 3 pills automaticity gives the character the poisoned condition and a level of exhaustion and disadvantage on all skill checks
Optional rule: Epileptic Surge
When a seizure occurs, this is due to the brain having an uncontrolled electrical disturbance. In the world of TTRPG, this can have an additional effect. Magic is everywhere and anyone is capable of it. Some have a natural affinity for it while others don’t but the potential is always there.
When a character has a seizure and rolls a constitution saving throw, on a roll of 1 or a roll of 20 you must roll 1 d100 to see the additional outcome of the seizure which triggers once the seizure is over.
Surge type
| Dice Roll | Surge type | ||
|---|---|---|---|
| 1 | Magic missile is cast at the closest creature to you at your highest spell slot level. If you do not have spell slots it is cast at 1st level | ||
| 2 | You summon 1d20 gold pieces scattered around you | ||
| 3 | You grow 5ft worth of hair on your head and a beard, even if you are unable to normally | ||
| 4 | Grass grows wherever you move for the next minute | ||
| 5 | You are under the effects of the jump spell for the next minute | ||
| 6 | You grow snake-like scales over your body until the next short or long rest | ||
| 7 | You gain the blind condition for 1d4 rounds | ||
| 8 | You gain true sight for 1 minute | ||
| 9 | Your size category is reduced by 1 until the next short or long rest | ||
| 10 | Your inner thoughts are heard out loud for the next minute | ||
| 11 | When you talk butterflies exit your mouth for the next minute (spell casting unaffected) | ||
| 12 | Any creature within 5ft of you takes extra 1d6 damage for 1 minute | ||
| 13 | Any weapon attacks you made gain 1d4 acid damage for the next minute | ||
| 14 | You summon 1d100 frogs | ||
| 15 | You summon 1d100 spiders | ||
| 16 | You summon 1d100 weasels | ||
| 17 | You cast Armour of Agathys on yourself and at any creature within 5ft of you at your highest spell slot level. If you do not have spell slots it is cast at 2nd level | ||
| 18 | You gain detect magic until your next short or long rest (without concentration) | ||
| 19 | You can cast the sending spell once without a spell slot until your next short or long rest | ||
| 20 | 1d4 trumpets are summoned and play your favourite song for 1d4 hours | ||
| 21 | You become invisible until the end of your next turn or you take an action to break it | ||
| 22 | You can breathe underwater until your next short or long rest | ||
| 23 | If you have spell slots you regain your lowest expended spell slot | ||
| 24 | You gain +2 strength until the end of your next long rest | ||
| 25 | You cast the darkness spell centred on yourself |
| Dice Roll | Surge type | ||
|---|---|---|---|
| 26 | You gain temporary hit points equal to twice your total character level | ||
| 27 | All your hair falls out but regrows in 24 hours | ||
| 28 | You polymorph into a bat for 1 minute | ||
| 29 | You can use any number of your hit die to heal instantly | ||
| 30 | You become immune to force damage for 1 hour | ||
| 31 | You gain an imp familiar until you finish a long rest or until it drops to 0 hit points (if you get this roll more than once it can be the same Imp or a different one) | ||
| 32 | You can talk to animals for 1 hour | ||
| 33 | You turn into a wooden Ventriloquist Dummy resembling yourself until the end of your next turn, you gain vulnerability to fire damage | ||
| 34 | You gain resistance to fire damage for 1 hour | ||
| 35 | You gain resistance to cold damage for 1 hour | ||
| 36 | You regain 5 hit points at the start of your turn for 1 minute | ||
| 37 | You gain 5 temporary hit points at the end of your turn for 5 minutes | ||
| 38 | An illusion is cast on you to appear identical to a random humanoid with 30ft of you which lasts for 1 hour | ||
| 39 | Your teeth fall out and regrow at the start of your next turn | ||
| 40 | You forget your favourite smell | ||
| 41 | Your favourite colour is now green | ||
| 42 | You cannot get drunk for 1d20 hours | ||
| 43 | You gain a tremor sense for 1 hour | ||
| 44 | An ability score of your choice is increased by 1 to a maximum of 20 | ||
| 45 | A random target within 30ft of you gains +1 to an ability score of their choice to a maximum of 20 | ||
| 46 | You gain proficiency in 1 skill of your choice | ||
| 47 | You lose proficiency in one skill of your choice until the end of your next long rest | ||
| 48 | You gain the service of a 2nd level spiritual weapon for 1 minute | ||
| 49 | Your highest level spell slot is consumed | ||
| 50 | Your skin turns invisible for 1 minute | ||
| 51 | Your current clothes/amour are sent to a pocket dimension and you are now wearing finely made plate mail. It disappears after 1 hour and your normal clothes/ amour are returned | ||
| 52 | All creatures with 30ft are pushed 10ft away from you | ||
| 53 | Mirror image is cast on you | ||
| 54 | Your strength and intelligence are swapped for 1d6 minutes | ||
| 55 | Gain x-ray vision for 1d20 hours | ||
| 56 | The weather changes to heavy rain, if already raining its now hail |
| Dice Roll | Surge type | ||
|---|---|---|---|
| 57 | A random common wondrous item appears in your space | ||
| 58 | A miniature rain cloud appears above you for 1d4 hours | ||
| 59 | You come under the haste spell (without concentration) | ||
| 60 | You learn a new language, chosen by the DM | ||
| 61 | You forget common for 1d4 hours | ||
| 62 | The next instance of damage you would take now heals you for the next hour | ||
| 63 | The next instance of damage you would deal now heals the target for the next hour | ||
| 64 | You grow large rabbit ears for 1d4 hours, gain advantage on hearing perception checks for this time | ||
| 65 | You gain a fey familiar in the form of a cat for the next hour | ||
| 66 | Your unarmed strikes deal 1d10 damage for 1 hour | ||
| 67 | You gain a tattoo of your favourite animal somewhere on your body | ||
| 68 | Your lowest ability score is decreased by 2 | ||
| 69 | You come under the effects of the Philter of love for 1 hour | ||
| 70 | You can cast Awaken as a single action once within the next minute | ||
| 71 | You learn a wizard cantrip of your choice, intelligence is the casting stat | ||
| 72 | You learn a druid cantrip of your choice, wisdom is the casting stat | ||
| 73 | Everything you eat and drink now tastes of blueberries for 1d20 hours | ||
| 74 | If you have a spell save DC it is increased by 1 | ||
| 75 | If you have a spell save DC it is decreased by 1 | ||
| 76 | Your movement is reduced to 0 for 1d4 rounds | ||
| 77 | All creatures within 30 feet of you are knocked prone | ||
| 78 | You gain spider climb for 1 minute,(without concentration) | ||
| 79 | You gain proficiency with one martial weapon | ||
| 80 | Your arms become tentacles for 1 minute, also gain advantage on grapple checks for this time | ||
| 81 | All light sources within a 60ft radius are extinguished | ||
| 82 | You cast Enlarge on yourself and 3 other creatures that you can see or hear (without concentration) | ||
| 83 | All weapons that are being held turn into poisonous snakes for 1 minute which take the dash action to move from their previous wielder, they maintain their size | ||
| 84 | All light, medium and heavy armour within 100ft of you becomes non-magical formal wear for 1 hour | ||
| 85 | Take psychic damage equal to half of your current health, a blood-red water elemental with HP equal to the HP you lost is summoned under your control until it reaches 0 hit points | ||
| 86 | You are immune to fear for 1d4 days |
| Dice Roll | Surge type | ||
|---|---|---|---|
| 87 | You come under the effects of the Dragon's Breath spell, you select the damage type | ||
| 88 | Anyone within 100ft of you automaticity loses concentration on spells | ||
| 89 | Anyone within 100ft of you must cast a level 1 spell if they can, with their highest spell slot | ||
| 90 | You summon a 20ft rainbow within 30ft of you | ||
| 91 | You polymorph into a T-Rex for 1 hour or until you drop to 0 hit points where you return to your normal form | ||
| 92 | You cast zone of truth centred on yourself with Charisma being the casting stat for the DC, you automaticity fail the save | ||
| 93 | You believe you have cast meteor swarm for 1 minute, you haven't | ||
| 94 | You believe you have become a sheep for 1 minute, you haven't | ||
| 95 | A random uncommon wondrous item appears in your space | ||
| 96 | An antique teapot appears in front of you with fully brewed delicious tea to serve 1d6 people | ||
| 97 | A wooden barrel appears in front of you, upon entering it transports you to a mansion from the spell Magnificent Mansion of the DM's design. After 24 hours the barrel disappears and the spell ends | ||
| 98 | A wooden barrel appears in front of you, upon anything entering it acts as a bag of devouring, it disappears after 1 hour | ||
| 99 | You turn into a gelatinous cube for 1 minute or until you drop to 0 hit points where you return to your normal form | ||
| 100 | You gain an inspiration point that can be kept until used |
This homebrew was designed by Isaac Cooke-Khan aka the GoodNaturedGamer https://linktr.ee/Isaac.CK
Made at www.naturalcrit.com