Ketogenic diet in children with epilepsy: A bibliometric and science mapping analysis of global research

The ketogenic diet has become an important therapeutic option for children with drug-resistant epilepsy; however, the structure and evolution of the related literature remain insufficiently clarified. This study aimed to map the global research landscape on ketogenic dietary interventions in pediatric epilepsy using bibliometric and science mapping methods.

Publications indexed in the Web of Science database were retrieved in January 2026. After screening and data cleaning, 983 articles published between 1989 and 2026 were included. Bibliometric analyses were performed using the Bibliometrix R package and Biblioshiny interface to assess publication trends, key contributors, collaboration networks, citation patterns, and thematic development.

Scientific output on ketogenic diet interventions in pediatric epilepsy has increased steadily over the past three decades, with a marked acceleration after 2014. A small group of core journals-most prominently Epilepsia, Seizure, and Epilepsy & Behavior-accounts for a large share of publications. The United States, China, and Italy are the leading contributing countries. Keyword and thematic analyses indicate a shift from early mechanistic and pharmacoresistance-focused studies toward broader clinical themes, including efficacy, safety, tolerability, growth outcomes, and alternative dietary approaches such as the modified Atkins diet.

The field of ketogenic diet research in childhood epilepsy has evolved into a clinically focused and increasingly multidisciplinary area. While seizure control remains central, emerging themes emphasize individualized treatment, long-term safety, and evidence-based standardization. This study clarifies research dynamics, intellectual frameworks, and knowledge gaps, providing a framework to guide future research and support clinical decision-making.