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does anyone have any clue what this could be?

my right hand and arm shakes and jerks I get facial ticks and if it happens at night when I'm trying to sleep I also start tapping my head and slapping it or push down hard on it and have vocal outbursts and trouble talking.any help on what this could be would be great thank you.

Update:

I don't think it is tourettes I am 32 but thank you for trying

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