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/MND may be so subtle that symptoms are overlooked or misread. The earliest symptoms may include: 1  Muscle weakness. 2  Muscle twitches (fasciculations). 3  Cramps and/or tight and stiff muscles (spasticity). 4  Muscle loss and/or atrophy. 5  Slurred and nasal speech. 6  Difficulty chewing and swallowing. 7  Excessive choking. 8  Excessive shortness of breath. 9  Unintended weight loss.