A regulatory framework Although common in other process manufacturing industries (e.g., food and chemicals), continuous processing is at a nascent stage in the pharmaceutical industry, where batch manufacturing is the prevailing mode.
When the motor neurons in the brainstem are affected (bulbar ALS), the muscles used in speech and swallowing are impaired. ALS only affects muscles that are moved voluntarily (such as those in the mouth or arm) and does not impact those muscles involved in involuntary movements, such as digestion.
Not all people with ALS experience the same symptoms or the same sequences or patterns of progression. However, progressive muscle weakness and paralysis are universally experienced. Gradual onset, painless, progressive muscle weakness is the most common initial symptom in ALS.