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One of my players is thinking of playing some sort of undead race that can cast spells. How would a worm/wormspawn affect him? We're about to start chapter 7.
I would say, let him/her take the intelligence damage and perhaps invent a suitable willsave against the voice of Kyuss.
After that you could offer a (perhaps slightly modified) version of the Wormhunter prestige class to the player, which could be a fairly cool development of that character.