Objective: The case of Ludwig II, King of Bavaria, had soon become synonymous with paranoia, after he had drowned at the age of 40 together with the neuropsychiatrist Gudden.
Method: We were granted access to the Secret Archive of the House of Wittelsbach to study documents on Ludwig's medical history.
Results: The documents underlying Gudden's expert opinion which led to Ludwig being deposed would be insufficient for a diagnosis of schizophrenia according to contemporary standards. The autopsy revealed prominent prefrontal brain atrophy.
Conclusion: The evidence is compatible with a diagnosis of schizotypal personality and suspected frontotemporal degeneration.