# Gene Testing Primarily EM **URL:** https://forum.livingwitherythromelalgia.org/t/gene-testing-primarily-em/4067 **Category:** General **Created:** [July 30, 2019, 11:40am UTC](https://forum.livingwitherythromelalgia.org/t/gene-testing-primarily-em/4067 "2019-07-30T11:40:44Z") **Posts on this page:** 1 **Showing post:** 4
### Author: ![anon16865673](https://avatars.discourse-cdn.com/v4/letter/a/919ad9/32.png) [@anon16865673](https://forum.livingwitherythromelalgia.org/u/anon16865673) #### Post date: [July 30, 2019, 4:06pm UTC](https://forum.livingwitherythromelalgia.org/t/gene-testing-primarily-em/4067/4 "2019-07-30T16:06:38Z")
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** > [@Helpful Cumulative Review Paper](https://forum.livingwitherythromelalgia.org/t/helpful-cumulatfuive-review-paper/3572): > > Hey everyone, So I am currently undergoing IV Prednisone and am on day 4 with no relief so far so I spent the afternoon researching papers for other options. Doing so I always found that looking through all the papers was daunting and I often found myself reading the same papers over and over again. This afternoon I came upon this cumulative review paper that covers all published papers on EM, it was published in August of 2018. It talks about all the different treatment options and reasons beh… **Primary EM cases treated with continous IV lidocaine** > **[Lidocaine and Mexiletine Therapy for Erythromelalgia](https://jamanetwork.com/journals/jamadermatology/fullarticle/478089)** > > A 25-YEAR-OLD white man presented with a lifelong history of severe, sometimes excruciating pain in his legs, which were constantly red and hot. He insisted on having his legs and feet constantly in ice water to relieve his severe discomfort. He... [![](https://canada1.discourse-cdn.com/flex027/uploads/ben_erythromelalgia/original/2X/3/3c6f42f249bbbab1661bff9f013bfc2760471824.jpeg "Ryan Junes - Erythromelalgia") ](https://www.youtube.com/watch?v=ULydWVhsnk4) --- _[View the full topic](https://forum.livingwitherythromelalgia.org/t/gene-testing-primarily-em/4067)._