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Objective: The aim of the study was to investigate the possible association between the 2D:4D ratio and epilepsy in male and female adults, and to compare the ratios of epilepsy patients and healthy control subjects. Patients and Methods: A case-control study carried out at a neurology and biophyiscs department in Ankara Yıldırım Beyazıt University, Faculty of Medicine from May 2016 to January 2017. The 2D:4D ratios of both the left and right hands of 172 epilepsy patients and 202 matched healthy controls were recorded. All participants also completed the Edinburgh handedness inventory. Results: A significant positive correlation between the 2D:4D ratio and epilepsy was found for both females and males; a lower ratio for the left hand was associated with a higher possibility of epilepsy. In addition, a lower ratio in a specific hand was associated with that hand being used to complete the handedness test. Conclusions: The 2D:4D ratio serves as a predictor for increased risk of epilepsy. Thus, it could be used as a marker to differentiate patients with epilepsy from healthy controls. [ABSTRACT FROM AUTHOR]