Le tremblement essentiel : où en sommes-nous?
Bibliographic record
Abstract
Resume Objectifs : Discuter des modalites de traitement du tremblement essentiel. Source des donnees : Une revue de la documentation scientifique portant sur la pharmacotherapie du tremblement essentiel a ete effectuee en recherchant des articles a partir de Pubmed entre 1975 et 2015 a l’aide des mots-cles suivants : adult, alprazolam, atenolol, benzodiazepines, botulinum toxin, clonazepam, deep brain stimulation, diazepam, essential tremor, gabapentin, lorazepam, metoprolol, nadolol, pediatrics, pharmacotherapy, phenobarbital, primidone, propranolol, sotalol, thalamotomy, topiramate. Les lignes directrices de l’American Academy of Neurology sur les traitements du tremblement essentiel revisees en 2011 ont egalement ete consultees. Analyse des donnees : Le faible nombre d’essais cliniques a repartition aleatoire publies et le nombre de patients inclus dans ces etudes sont deux problemes frequemment associes a la majorite des traitements etudies pour le tremblement essentiel. De plus, les outils utilises dans les essais cliniques pour evaluer l’efficacite des traitements a l’etude ne sont pas toujours bien decrits, ce qui rend l’interpretation des donnees complexe. Aucun essai clinique a repartition aleatoire n’a ete publie sur le traitement du tremblement essentiel de l’enfant et de l’adolescent. Conclusion : Le tremblement essentiel est une maladie mal connue. Les traitements pharmacologiques ne permettent pas de guerir la maladie, mais vont plutot attenuer les symptomes. Le propranolol et la primidone demeurent les agents pharmacologiques de premiere ligne pour l’adulte. Pour l’enfant et l’adolescent, la pharmacotherapie est rarement necessaire, bien que le propranolol soit parfois utilise en premier recours dans les cas plus severes. Abstract Objectives: To discuss the treatment options for essential tremor. Data source: A review of the literature on the pharmacotherapy of essential tremor was conducted by searching PubMed from 2005 to 2015 for articles, using the following keywords: adult, alprazolam, atenolol, benzodiazepines, botulinum toxin, clonazepam, deep brain stimulation, diazepam, essential tremor, gabapentin, lorazepam, metoprolol, nadolol, pediatrics, pharmacotherapy, phenobarbital, primidone, propranolol, sotalol, thalamotomy, topiramate. The American Academy of Neurology’s 2011 revised guidelines on the treatments for essential tremor were also consulted. Data analysis: The small number of published randomized clinical trials and the number of patients included in these studies are two problems frequently encountered in the literature review for the treatment essential tremor. Furthermore, the tools used in clinical trials to evaluate their efficacy are not always clearly described, which makes interpreting the data a complex task. No randomized clinical trial has been published on the treatment of essential tremor in children and adolescents. Conclusion: Essential tremor is a poorly understood disorder. The pharmacological treatments are not a cure but rather alleviate the symptoms. Propranolol and primidone are the first-line pharmacological agents in adults. In children and adolescents, pharmacotherapy is seldom necessary. Propranolol is sometimes used as first-line therapy in more severe cases.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.008 | 0.057 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.004 | 0.005 |
| Science and technology studies | 0.001 | 0.002 |
| Scholarly communication | 0.004 | 0.006 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.010 | 0.003 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".