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.
Most people with ALS first feel muscle cramps, spasms or twitching (fasciculations) in one of their arms or legs. Other signs include weakness in the hands and feet or loss of balance. This form of the disease is called limb-onset ALS. About 25% of people with ALS first have trouble talking clearly - slurring words.