<s>[INST] H.. I have a patient diagnosed with pml,  they are using experimental treatment of cidofovir, she has r sided paralysis, dysarthria, and mental confusion, but has developed a hyperventilating type of respiratory pattern when she is sleeping,  any ideas, diease progression? [/INST] Thanks for your question on Chat Doctor. I can understand your concern. PML is progressive multiple leukoencephalopathy. It is progressive disease of brain. Hyperventilation at night in these patients is suggestive of respiratory center involvement. This is also suggestive of worsening disease. This kind of patients also show daytime hyperventilation and ultimately succumb to death. BiPAP device is useful for respiratory problems. Hope I have solved your query. I will be happy to help you further. Wishing good health to your patient. Thanks. </s>