You should really look into getting a dual-monitor setup. I find it indispensable, and I suspect it might make your life, in particular, a little bit easier.
Guess it depends on how paralyzed the OP is.
It seems however, if possible, a head tracker is the best option.
On this page is a video of a quadriplegic player using a head tracker to play fast action games like Counterstrike. I can only presume if he can pull that off with this stuff then a game like Civ should be no problem.
I think this is the unit used in the video (or one like it). I have no experience using these so this is not a recommendation for this one. Just to give the idea. I presume there are competitors out there but again I do not know.
$500 is not cheap but I’d spend it in a second to be able to play my games again.
ETA: I also have no idea how difficult it is to become proficient with one of these. Doubtless there is a learning curve.
I’ll jump on the dual-monitor bandwagon. As much as I find it useful to be able to work on two screens - blinkie, you seem to have the perfect use case for it. Given the price of monitors these days (cheap), it’s worth looking into.
I can’t believe I’m the first person to bring up Kingdom of Loathing.
I second the Rogue-likes. NetHack* is great (especially as a male archaeologist named Indy!), but I’m partial to Tales/Troubles of Middle Earth. ToME is especially fun for Tolkien fans, of course, but its also a solid game by itself.
Depending on exactly how good with a mouse you are, Master of Orion 1 and 2 are outstanding games that are turn-based. Both are mouse-intensive, but at pretty much the same level CivIV or any 4X game is. For that matter, most games of that genre are perfect for un-rushed play.
Finally, there’s always tabletop RPGs. There are plenty of places to do it online via forums and for Dungeons & Dragons, you don’t even have to buy the books, the base rules are offered free.
*- pedescribe already had the link, but I’m too lazy to edit the sentence. 
In between games and websurfing, I always end up going back to Freecell. In case you haven’t played it, it’s similar to Solitaire, but there’s no luck involved. Every game is winnable. It can be played completely with the number keys. I use this one: FreeCell Pro , Freecell Pro 6.4 (free), because it’s more configurable than the standard Microsoft one, and if I want a challenge, I can play with 3 free cells instead of 4.
There are other game styles you could get into as well, if you have adequate mouse control, specifically RTS and RPG games.
See, while playing a fast action game may cause some control issues, many RTS and RPG games can be paused in the middle of the action, and new commands issued.
Examples I can think of…
Neverwinter Nights 1&2. Good d&d based rpgs. Rather linear, but fun.
Homeworld:Cataclysm and Homeworld 2. Wonderful space based RTS games. Sadly, the original homeworld doesn’t allow one to issue commands while paused.
If these pique your interest, I’m sure we could come up with more examples for you to choose from.
Also, mirroring other peoples comments, a dual screen setup so that you can have the keyboard active would be very beneficial. This will work for most games, but perhaps not all. Some few games do not like playing windowed, and will minimize if you focus on another application.
One other thought… Would perhaps something like this be of any use? I know the ‘mind readers’ don’t work all that well, but it could very well give you some extra control options that you didn’t have before.
Really? Already almost 50 posts and not one of you has suggested Blood Wars or at least persuading him to get into Halo by watching every episode of Red vs Blue?
It is for shame.
Nevertheless, as people have suggested, Civ4 is clearly the best of the Civ games released to date, but if you like the style and aren’t afraid of stepping back the graphics by a generation or two, you might be able to find a copy of Sid Meier’s Alpha Centauri and its expansion Alien Crossfire, both of which (IIRC) could be played exclusively by keyboard.
But again, how much mouse control do you have?
blinkie, you’re an inspiration. i’m glad they were able to help, I wish I had!
Just got on civilization 4 awesome:d:d
Fantastic. Don’t forget that there are a lot of people here who can help you with strategy if you need it!
Hey blinkie if you manage to put down Civ4, slashdot had a link to ablegamers.com They have reviews of games with added accessibility info.
They have a forum for people to ask/answer “howto” questions. Unfortunately it doesn’t look real busy, but it might help you out. They also have a review of some on-screen keyboards similar to what you use, but with an eye to gaming, unfortunately I had it, then lost the link.
We only let Bloods into our Nerd Gamerz Crew.
There are a lot of Facebook games that are point/click if you can use the mouse.
I’m wandering around Cv 4 now. Took me awhile just to get through the tutorial. There were a few glitches with the system I use and the game but now I’ve gotten them straightened out.
And Montezumas a psycho, if you start close to him arm yourself early and often.
Late to the party on this one, but here is an article with some resources of a quadriplegic who plays High end raiding on World of Warcraft. Hope it helps!
quadriplegic-player-attacks-progression-raid/
Dwarf Fortress!!!
the download Bay 12 Games: Dwarf Fortress
the wiki dwarffortresswiki.net
and a must read Boatmurdered Dwarf Fortress - Boatmurdered
ugly as sin but fun as hell.
:DI don’t know whether I should love or hate you guys. Spent ALL day in Civ. Can barely see, but I’m going back for more now.
Yep, you’re a gamer all right. No turning back now :).
It’s OK. Just one more turn and you’ll go to sleep. Just one more turn. You can stop whenever you want. Ooh, new tech. OK, one more turn. 