Central hearing loss is generally thought to be extremely rare compared to the sensorineural or conductive types of hearing loss, but recent studies has shown that central components to hearing loss are much more common than previously appreciated. The diagnosis is usually not made by the pure tone audiogram, which in fact, is often normal. Rather patients usually have poor scores on speech reception threshold (SRT), or word recognition scores (WRS) portions of the audiogram. Rather than relying on the audiogram, this diagnosis is best made by combining an audiogram demonstrating good pure-tone recognition, with specialized aphasia testing. Inconsistency between pure-tone recognition and speech is another way to recognized central impairment. In TCM, central hearing loss is mainly caused by the deficiency of liver, blood stasis due to qi stagnation, and attack by wind and heat.