DEAR DR. DONOHUE: My 8-year-old granddaughter is a bright, active, lovable child, but she has a habit of drifting off to some distant place even when someone is talking to her. These “spells” were increasing, and her teacher noted them. My daughter took her to a doctor who referred them to a neurologist, who diagnosed petit mal epilepsy. We’re quite upset about this. What can you tell me about it?

She’s on medicine now. Will she take it for life? Will this interfere with learning? – L.L.

ANSWER: Petit mal epilepsy is now called “absence seizures.” All seizures are the result of a sudden discharge of electrical activity by brain cells. With absence seizures, there are little to no muscle contractions, no unconsciousness and often, observers do not realize that anything is wrong with the affected child.

The seizure is more like a sudden staring spell where it seems that the child is briefly, for a few seconds, transported to another place and doesn’t react to those around or to the calling of his or her name. During the spell, facial muscles might twitch or the child sometimes makes chewing movements with the mouth or smacks the lips. Most often, there are not any great manifestations that a seizure has occurred.

The causes include a former nervous-system infection, an old scar in the brain, head trauma or, as in most cases, no known cause.

Now that your granddaughter is taking medicine, her seizures should become less and less frequent and might be totally eradicated. Her learning ability will not be compromised in any way, nor will her ability to participate in school activities.

Quite often, children with this kind of epilepsy outgrow it in their teen years and can stop taking medicines.

DEAR DR. DONOHUE: I had chest pains that the doctor called angina and gave me medicine for. Then I had to have bypass surgery. Now I have stomach pain that the doctor calls abdominal angina. It happens mostly after I eat, and I have grown fearful of eating. What is this? How is it treated? – J.K.

ANSWER: Chest pain that comes on with exertion is angina pectoris. It’s due to the plugging of heart arteries with a buildup of cholesterol and other material. The buildup cuts back the blood supply to heart muscle. Therefore, when a person moves around and makes the heart work harder, that person’s heart cries out in pain because it’s not getting enough blood. Stopping the activity relieves the pain.

You have a similar situation in the arteries to your digestive tract. Abdominal pain arises, most of the time after eating, because the digestive tract needs more blood at that time to digest food.

I don’t know if you have had any tests to detect the blockage or blockages, but X-ray pictures or scans of those arteries, after dye has been injected, demonstrate the obstruction.

Abdominal angina is treated similarly to heart angina. The blocked arteries can be replaced with grafts, or they can be propped opened with stents.

DEAR DR. DONOHUE: For about five months, my husband had fainting spells. We don’t have a doctor, so he finally went to a medical clinic, where they took an EKG. They called to say he has a third-degree heart block and should see a doctor. What does all this mean? How urgent is it? – V.B.

ANSWER: A third-degree heart block is quite urgent. Your husband has to see a doctor as soon as possible. I hope he has seen one before you read this.

A third-degree block means that no electrical impulses from the heart’s natural pacemaker are reaching the heart’s lower pumping chambers. That slows the heartbeat considerably, often to the point where too little blood gets to the brain and the affected person passes out.

Your husband needs an artificial pacemaker, and the sooner he sees a heart doctor, the better off we all will be.

DEAR DR. DONOHUE: Is there a truly diagnosable condition known as chronic fatigue syndrome? I recall hearing of it some years ago. Now my granddaughter might have it. – H.L.

ANSWER: Most doctors subscribe to the existence of chronic fatigue syndrome. It’s a complicated illness without a known cause, without any diagnostic test and without a medicine that works for all patients.

We all understand acute fatigue – the weariness that comes from hard physical or mental work and that responds to a night’s rest. Chronic fatigue, on the other hand, is fatigue that lasts at least six months. Sleep doesn’t relieve it. People wake up as tired as they were when they went to bed. Often, they have a hard time concentrating, and their memory doesn’t work as well as it used to. Some complain of a sore throat that lingers, others of tender muscles, and still others of frequent headaches or swollen lymph nodes.

In approaching patients suspected of having chronic fatigue syndrome, doctors must look for medical and psychiatric conditions where fatigue is prominent. They have to consider such things as multiple sclerosis, a misfiring thyroid gland, anemia, diabetes, depression, infections like TB and even cancers. Only when fatigue-causing illnesses have been checked and not found can the diagnosis stand on firm ground.

What to do for the syndrome is as perplexing as the syndrome itself. Staying as active as possible allows patients to avoid a breakdown in muscle conditioning. And a modest exercise program generates body chemicals that fight fatigue. Ten minutes of walking, or even less if 10 minutes is too exhausting, is a good starting point. People should increase the walking sessions to two and then three times a day, and then lengthen the amount of time they walk. Amitriptyline, an antidepressant, is often prescribed for its ability to restore normal sleep. Cognitive behavioral therapy helps patients regain control of their lives. Your granddaughter should seek help from her family doctor.