Although diplacusis is usually indicative of cochlear pathology, to our knowledge causes in the central nervous system ("central diplacusis") have not been mentioned in the available literature. A case of central diplacusis involving a lesion in the posterior thalamus is now reported that resulted in diplacusis binauralis. A neuro-audiological explanation is offered to explain this phenomenon. Presumably, a lesion at the geniculate-collicular level, where pain and tactile impulses are interrelated with auditory, visual and olfactory ones, leads to the phenomenon perceived.