Orlando, 14, 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. Orlando has had this problem since he was 8. The most likely diagnosis is

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Orlando exhibits multiple motor tics and at least one vocal tic, which are the main symptoms of Tourette's syndrome. The urge to engage in these movements and sounds is also a characteristic of the disorder. The symptoms usually appear before the age of 18 and can continue throughout adulthood. Obsessive-compulsive disorder may involve repetitive behaviors, but not necessarily in the form of tics. Coprolalia is a specific type of vocal tic that involves the use of inappropriate or taboo words, which Orlando does not exhibit.

Orlando, 14, Frequently Twists His Head Uncontrollably and Yelps or Grunts