All of the following are features of Parkinson disease EXCEPT:

Correct answer: A. Visual loss

• A. Correct — this is the exception. Parkinson disease does not cause loss of vision. It is a movement disorder from dopaminergic degeneration in the substantia nigra.
• B. Bradykinesia, the slowness of movement once begun, is required for the clinical diagnosis.
• C. Akinesia — difficulty initiating movement — is a cardinal feature and shows up as the characteristic hesitancy in starting to walk.
• D. A resting tremor, classically pill-rolling and improving with voluntary movement, is the third cardinal sign alongside rigidity.

Note: Practical implications: reduced blink and drooling, difficulty with oral hygiene, and a real risk of orthostatic hypotension from levodopa when the chair is raised.