In response to a viral infection (like viral meningitis or the herpes simplex virus), facial nerves can swell and become inflamed, leading to paralysis of the face (or bell’s palsy). In most bell’s palsy cases, symptoms—which include twitching, weakness, paralysis, drooping of the eyelid or mouth, drooling, and dry eye—start suddenly and peak within two days. Studies have shown that some steroid medications effectively reduce the inflammation and swelling associated with bell’s palsy—and some antiviral drugs may stop the infection from progressing. Most people see symptom improvement in about two weeks and full recovery within three to six months. However, recovery time will depend on the severity of the nerve damage. Decompression surgery is no longer recommended to treat bell’s palsy, because it has been shown to increase the risk of permanent hearing loss and nerve injury. Physical therapy treatment of bell’s palsy can be particularly effective in stimulating the facial nerves and helping maintain muscle tone to prevent permanent muscle contracture. Physical therapy also can help prevent recurrence through facial muscle massage and exercise education. Applying moist heat and taking over-the-counter pain relievers as well as performing alternative medicine techniques, such as relaxation exercises, acupuncture, biofeedback training, and vitamin therapy, also may be beneficial.