# A Study on the Essential and Parkinson's Arm Tremor Classification +
## 2 Essential and Parkinson's Tremor
### Parkinson's Tremor: Overview and Diagnosis  
[PERSON]'s disease [43] is one of the most common neurodegenerative diseases, with a frequency of about 1% in the population over 65 years. It is the main representative of the exopyramidal diseases and is a result of the destruction of nerve cells in the brain, resulting in incomplete production of dopamine, with consequences in unusual brain activity. In more detail, [PERSON]'s disease may have a genetic cause or be due to exposure to certain toxins, in the presence of lewy particles together with a-synucleinons, as well as in other factors such as age and gender. The symptoms begin gradually, often with tremor occurring in one hand. PT usually occurs at rest, i.e., when the hand is not working, but remains motionless. In the early stages of the disease, it has been observed that facial expressions are reduced, hands begin to vibrate when walking and the voice becomes softer. Other symptoms may be the change in handwriting, imbalance and reduction of automated movements [44]. In addition, [PERSON]'s disease may be responsible for depression and emotional swings, difficulty in thinking, swallowing problems, sleep disturbances, sudden pressure drop, sexual dysfunction, etc. However, it is important to mention that [PERSON]'s disease is not by itself fatal. The life-threatening factor is subject to the fact that because of these symptoms, the person could cause involuntary self-harm. For example, it is possible because of the lack of balance to fall and cause serious injuries or to aspirate food to the lungs causing pneumonia and other lung diseases. Until today, the diagnosis of [PERSON]'s disease is primarily based on the clinical picture of the patient [45]. More specifically, the chances of a person suffering from the disease Parkinson's increase as the following symptoms increase, the observation of which stems from daily life tasks:  
* some daily activities are accomplished slower than in the past,
* balance problems,
* the letters become smaller when writing,
* tremor appears in the palm, hand, lips and legs,
* muscle stiffness,
* problems when walking (confused feet, step diminishes),
* the feeling that the feet are stuck on the floor,
* one hand remains motionless when walking,
* change in voice and sound pitch,
* difficulty of the person to get up from a seated position,
* weakness when fastening a garment. \begin{table}
\begin{tabular}{c c c c c} \hline
**Body Part** & **1** & **2** & **3** & **4** \\ \hline Face or tongue & Slightly visible & Visible &
\begin{tabular}{c} Obvious in most \\ facial expressions \\ \end{tabular} & Intense, deformable \\ Voice & Slight in voices such as & Visible in voices & \\ Voice & “eee” or “aaa” & such as “eee” or “aaa” & Visible during speech & Difficulty in understanding \\  & & and slight during speech & & certain words \\ Upper limb & Barely visible & 1–3 cm & 5–10 cm & 20 cm \\ Lower limb & Barely visible & Visible but feckless & 5 cm & 5 cm \\ Writing & Barely visible & Visible, all words & Visible, most of the \\  & & can be read & words can be read & No word can be read \\ Dot approximation task & Barely visible & 1–3 cm & 5–10 cm & 20 cm \\ Upright position & Barely visible & Visible but feckless & Moderate & Severe \\ \hline \end{tabular}
\end{table} 
Table 1: The Essential Tremor Rating Assessment Scale (TETRAS) [42]. At this point, a reasonable question is whether the specific symptoms are found to be capable of deciding whether the patient is suffering from [PERSON]'s disease. The answer to the above question is not easy and even depends on two key factors. First and decisive factor is the stage of the disease. Often in its early stages, PT can be confused with the syndrome of ET. Other times the pharmaceutical administration of anti-psychotic drugs to combat depression or even treatment of drugs to cure nausea cause PT. In addition, the syndromes of progressive supranuclear palsy [46]) and the normal pressure Hydrocephalus [47] cause symptoms similar to [PERSON]'s disease.