I have a few thoughts after reading your request and checking your profile. It appears this is your middle son, and there's been a new baby in the family for about the past year?
If so, you might get some great ideas and support from the book Siblings Without Rivalry. Your son could feel he's competing for your attention, and this is one way he's found that actually works. You'll want to help him find more positive means of getting the attention he craves, and be sure you're making lots of opportunities to cuddle him and laugh with him and take interest in what he's doing when he's NOT being demanding.
The fact that he seems confused may or may not be significant. If it's a control issue, he's simply relying on the behavior that gets the results. Even if it's not the connection with you he would prefer, it could be the response from you that he's learned to settle for.
But if the confusion is medical in nature, there are at least two things that could be contributing. Possible (though rare and unlikely) are disorders like epilepsy or Tourette syndrome. Somewhat more likely would be sensory processing issues. You can check out your son's behaviors and preferences on this useful checklist: http://www.sensory-processing-disorder.com/sensory-proces...
One other thought is that he may have other sensitivities/allergies that make him physically or mentally uncomfortable and hard to please. He might be sending out signals for help but have no real idea why, if he's just always at odds with his own body.
I have severe chemical sensitivities, and get both physical and emotional symptoms to exposures to perfumed toiletries, home cleaning products, fabric softeners and air "fresheners." In group testing situations, I have watched children go from contentedly coloring to bouncing off walls, screaming, crying, or being impossibly stubborn a minute or two after diluted substances were placed under their tongues. It would be worth checking out if nothing else works. You can try sealing all suspicious products in plastic bags and using baking soda or vinegar for most cleaning for the next 2-3 weeks, and watch for any improvements in your son. If reintroducing the products (many of which are toxic, anyway) back into the home then results in worse behavior, you'll have a possible solution to work on.