Oscar is thirteen and frequently twists his head uncontrollably, and yelps or grunts. If he has not done this for several hours, he has a sensation that can only be relieved by engaging in these movements and sounds. Oscar has had this problem since he was nine. The most likely diagnosis is .

The most likely diagnosis is Tourette's syndrome.

Explanation:

Tourette's syndrome usually begins in childhood, has a chronic course and a dysfunctional or disabling character. The initial symptoms consist of motor tics of the head and face that subsequently spread progressively to the trunk and lower extremities, without having to fulfill the cephalocaudal progression of motor tics in all cases, and it is difficult to distinguish them primarily from a picture of transient tics, and one or more vocal tics, vocal tics may appear at a given moment, in isolation, and the same with multiple motor tics. Motor tics include, but are not limited to: grimacing, gesturing, blinking, eyebrow raising, neck twitching. In the case of vocal tics, these include: repetitive emission of sounds and words, throat clearing, screaming, various guttural sounds.

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