Extracellular potassium dynamics in the hyperexcitable state of the neuronal ictal activity

An enduring question in epilepsy research concerns with the mechanisms responsible for the neuronal hyperexcitability. This theme is under debate and different hypotheses have been put forward. One hypothesis relates to extracellular ionic variations, especially the increase of the extracellular potassium concentration ([K+]o). During the epileptiform bursting, an increase of [K+]o is observed which raises the cellular excitability. It remains unclear, however, how the extracellular potassium variation could affect the generation and persistence of epileptiform bursting within the ictal phase, that is, during the epileptic seizure. The neuronal mechanisms responsible for this cellular hyperexcitability are not yet fully understood, hindering the development of more efficient therapies to control epilepsy. Mathematical models with biological plausibility have provided considerable insights into the mechanisms underlying epileptiform pattern. This paper reviews experimental evidences and computational studies concerning effects of the extracellular potassium dynamics on the cellular excitability within the neuronal ictal activity.