The neurologic complications of pertussis infection among 340 unvaccinated patients admitted to hospital between 1979-1994 are reported from the Pediatric Clinic of the University of Catania, Sicily. Fourteen (4.1%) developed neurologic complications: Seizures occurred in all cases, 4 with fever, and 3 with signs of acute encephalopathy, including obtundation and vomiting which lasted only 12 to 24 hours. None of the patients developed epilepsy, all attend regular schools in appropriate grades, and at 14-18 year follow-up, only one has a mild behavioral disorder as a possible sequel of encephalopathy. No serious neurologic complications or permanent sequelae were observed in this series of children hospitalized for pertussis infection. 
COMMENT. The relatively mild and benign nature of the neurologic complications of pertussis infection reported in this study contrast with the severity and permanent sequelae of some reported cases of pertussis vaccine encephalopathy. Seizures were not associated with anoxic episodes and coughing bouts and were not complicated by epilepsy.