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.
The onset of ALS may be so subtle that the symptoms are overlooked. The earliest symptoms may include fasciculations, cramps, tight and stiff muscles (spasticity), muscle weakness affecting an arm or a leg, slurred and nasal speech, or difficulty chewing or swallowing.hen symptoms begin in the arms or legs, it is referred to as âlimb onsetâ ALS. Other individuals first notice speech problems, termed âbulbar onsetâ ALS. Regardless of the part of the body first affected by the disease, muscle weakness and atrophy spread to other parts of the body as the disease progresses.