Glymphatic system and aquaporin‑4 in epilepsy

Over the past decade glymphatic concept has gained more and more interest. Despite some lacking data regarding structural and functional aspects, glymphatic system is widely considered the main mechanism of water and solutes transport in brain parenchyma, as well as waste clearance from the brain. Glymphatic system modulates the extracellular space volume and is involved in spatial K+ buffering (via influencing Kir4.1 channel functioning), two factors crucial for neuronal excitability and seizure susceptibility, and is itself strongly stimulated during sleep. This review summarizes information regarding the potential role of the glymphatic system in the development and progression of epilepsy, especially the role of the glial water channel aquaporin‑4 in modulation of brain excitability and in epilepsy. Data from animal models and human studies are presented.