There are a few categories of sodium channel blockers that can be used for primary EM (lidocaine, mexiletine, carbamazepine, oxocarbazepine). Sometimes mexiletine can take a few weeks or a couple of months to effectively reduce the sympathetic flow associated with EM. Here is a good cumulative review paper that I posted a year ago or so that covers everything. Lidocaine infusions have shown to be extremely effective in cases of primary EM in young patients with the possibility of complete remission, it is something to maybe look into (I’m surprised mayo clinic didn’t mention this). I must also add that the two successfully treated cases I’ve read about were done with continuous inpatient infusions over the course of a few days, while outpatient weekly infusions aren’t mentioned (they certainly could be successful, cases just aren’t coming to mind right now.)
Review Article
Primary EM cases treated with continous IV lidocaine
