Kikoteem

• Loss of Coordination
• Loss of control over muscle movement
• Headache and joint pain in the legs
• Tremours
• Difficulty swallowing and pronouncing words

On failed WIS saves during Ambulant or Sedentary stages, the following mental symptoms can occur:

d6	Symptom Onset (Lasts 1 minute)
1	Uncontrollable laughter, rendering speech incoherent
2	Frightened of silence
3	Sudden burst of rage or paranoia toward an ally
4	Panic – must use movement to flee target or ally
5	Fails to recognize familiar faces or locations
6	Freezes in place and unable to act (Stunned)

The incubation period averages between 10 - 13 years, but can be as short as 5 years and as long as 50 years after initial exposure. The clinical stage, which begins at the first onset of symptoms, lasts an average of 12 months.   Subsequent stages worsen based on failed saving throws, moving the character 1 stage closer to terminality. Successful saves halt progression for d20min10 days. Three failed saves in a row move the character directly to the next stage. The clinical progression is divided into three specific stages:

Ambulant Stages

One year after the first effects, the individual is still able to walk around despite symptoms. However, patients must succeed a DC 13 CON saving throw or suffer:

• Disadvantage on DEX (Acrobatics) and CHA (Persuasion)
• Disadvantage on initiative rolls
• Once per day, GM may require a DC 13 WIS save. On a fail, the character experiences inappropriate emotional outbursts (laughter, tears, confusion) for 1 minute, during which they have disadvantage on stealth and concentration checks.

Sedentary Stages

Where the infected individual is incapable of walking without support and suffers from severe tremors. Patients must succeed a DC 15 WIS saving throw or suffer:

• Half movement speed
• Cannot Dash or take reactions
• Disadvantage on all attack rolls
• Must succeed on a DC 15 DEX save to perform fine motor tasks

Terminal Stages

Where the infected individual's existing symptoms progress to the point where they are no longer capable of sitting without support. Towards the end of the terminal stage, patients often develop chronic ulcerated wounds that can be easily infected. Patients must succeed a DC 14 CON save every long rest after symptoms begin or suffer:

• 5ft movement per turn and requires assistance to sit upright
• 1 level of exhaustion that cannot be removed by rest
• Any slashing/piercing damage automatically causes a wound that becomes infected after 24 hours (DC 15 Medicine check to preempt)
• Every dawn, make a DC 14 CON save or gain another level of exhaustion
• Spellcasting is impossible without magical assistance

Step Folk

In the olden days, kikoteem was 8 - 9 times more prevalent in women and children than grown men. The disparity was due to ritual cannibalism, where the deceased were honoured by consuming their flesh.   In their society, it was predominantly women and young children who prepared and consumed the brains of those who died of old age or other natural means. Adult men, by contrast, only partook of brains of warriors who died in violent combat.