Encephalitis is an acute inflammation of the brain. Encephalitis with meningitis is known as meningo encephalitis. Symptoms include headache, fever, confusion, drowsiness, and fatigue. Further symptoms include seizures or convulsions, tremors, hallucinations, stroke, and memory problems. In 2013 encephalitis was estimated to have resulted in 77,000 deaths, down from 92,000 in 1990. Adult patients with encephalitis present with acute onset of fever, headache, confusion, and sometimes seizures. Younger children or infants may present irritability, poor appetite and fever. Neurological examinations usually reveal a drowsy or confused patient. Stiff neck, due to the irritation of the meninges covering the brain, indicates that the patient has either meningitis or meningo encephalitis. The signs and symptoms of tick born encephalitis are: The virus can infect the brain (encephalitis), the meninges (meningitis) or both (meningoencephalitis). In general, mortality is 1% to 2%, with deaths occurring 5 to 7 days after the onset of neurologic signs. In dogs, the disease also manifests as a neurological disorder with signs varying from tremors to seizures and death. In ruminants, neurological disease is also present, and animals may refuse to eat, appear lethargic, and also develop respiratory signs.