Approach to neurodevelopmental disorders Quiz: Ace Your Exams
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A 9-year-old boy is brought to the psychiatry clinic for a 13-month history of frequent involuntary movements and vocalizations. Caregivers describe repeated eye blinking, facial grimacing, and grunting. These behaviors worsen when he is nervous or excited. The patient is aware of these concerns and feels an urge to act on them before the symptoms occur. Teachers have observed similar behaviors but note that concentration, grades, and social interactions remain excellent. Temperature is 37.0°C (98.6°F), pulse is 80/min, respirations are 15/min, and blood pressure is 96/60 mmHg. Cardiopulmonary examination is normal. Mental status examination shows a well-appearing child in no acute distress. Complete blood count (CBC), complete metabolic panel (CMP), and thyroid studies are normal. Which of the following is the most likely diagnosis?
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