Volume III, Issue V, May 2016 IJRSI ISSN 2321 – 2705 www.rsisinternational.org Page 21 Understanding Essential Tremors: A Review Sumit Kr. Choudhary 1 , S. L. Vaya 2 , Parvesh 3 , Preeti Sherawat 4 1 Assistant Professor, Raksha Shakti University, Meghaninagar, Ahmedabad, Gujarat, India 2 Director, Research and Development, Raksha Shakti University, Meghaninagar, Ahmedabad, Gujarat, India 3 Lab Technician; Raksha Shakti University, Meghaninagar, Ahmedabad, Gujarat, India 4 JRF, Raksha Shakti University, Meghaninagar, Ahmedabad, Gujarat, India Abstract: - Tremor being the commonest physiological disorder seen in most of the population is still believed to be early as sign of aging. Although tremor can be seen in earlier phases of life, many people feel that tremors are a part of aging and fail to report them to their physicians which hinder the treatment at initial stages. Tremor is indicated by an involuntary and rhythmic movement of the pen from side to side, resulting in irregular and shaky handwriting. Some tremors are more obvious to come in handwriting of the person actively or anxiously involved in some physical work without any emotional and chemical cause behind it. Such types of tremors are commonly known as essential tremors (ET) and are often mistaken with other forms of tremors in handwriting such as that due to age, forgery and some serious pathological and psychiatric disorders. This article will provide the reader with basic insight about essential tremors, their signs and symptoms and measures that can be taken to minimize the growth of such class of neurological disorder. Keywords: Forensic, document, examination, tremors, essential tremors, handwriting I. WHAT ARE ESSENTIAL TREMORS? orensic document examiner is often confronted with handwriting depicting tremulous stroke raising doubt about its genuineness. Tremors in handwritings can be attributed to various rationales, such as age, illness, weak neuro-muscular coordination, forgery, illiteracy, drug or alcohol, intoxication, writer’s cramp and pathological or psychiatric disorders 1,2 . While motor signs such as slowness, muscle rigidity, and postural instability, is generally associated with a Parkinson syndrome, tremor is more ubiquitous. Tremor can develop in people, regardless of age, for many reasons, including fear, fatigue or anger or due to side effects of too much caffeine, a medication, or withdrawal from a drug or medicine 3 . Such neurological condition in which tremor is a main feature is essential tremor (ET) 4,5 . Essential tremor is a progressive neurological condition that causes involuntary rhythmic trembling of the hands, head, tongue, voice, and less often the legs or trunk 6 . Like Parkinson's disease, ET is considered a movement disorder. The disease can occur because of abnormal communication between certain areas of the brain including the cerebellum, thalamus, and brain stem. Usually essential tremors begin more often in dominant hand of the writer 6,7 . Writers can experience it during every basic task performed by them during their normal routine course like pouring beverages in glass or cup, writing on document, typing on mobile phones or tablets, threading a needle etc 8 . II. SIGNS AND CAUSES OF ESSENTIAL TREMORS ET is usually initiates on one side of the body and gradually increases with the movement. Hands are more prone to such tremors than any other body part. Emotional misbalance, fatigue, psychological and mental dependencies and temperature variations catalyses the process of tremor 9,10 . Other symptoms for ET include:  Uncontrollable shaking that occurs for brief periods of time  Shaking voice  Nodding head  Tremors that worsen during periods of emotional stress  Tremors that get worse with purposeful movement  Tremors that lessen with rest  Balance problems (in rare cases) The true cause of essential tremor has always remained the mystery, but it is thought that the abnormal electrical brain activity that causes tremor is processed through the structure deep in brain 11 called as thalamus 12 that coordinates and controls muscle activity. Researchers also predict that they are the genes causing ET in half of all people with the condition. A child born to a parent with ET will have up to a 50% chance of inheriting the responsible gene, but may never actually experience symptoms 13 . Although ET is more common in the elderly and symptoms become more pronounced with age it is not a part of the natural aging process. Several genes as well as environmental factors likely help determine an individual's risk of developing this complex condition 10 . The specific changes in the nervous system that account for the signs and symptoms of essential tremor are unknown 11,14 . Essential tremor can be passed through generations in families, but the inheritance pattern varies 15 . In most affected families, essential tremor appears to be inherited in an F