Dr. Rami Burstein of Harvard University and his colleagues discovered the way to predict who is going to respond to Botox injections. Patients who have pain that is constricting, crushing, or “imploding” with pressure going from outside in and those with pain in the eye respond much better than those whose pain is “exploding” or with a sensation of pressure building up from inside the head. This was true for patients with episodic, as well as chronic migraine headaches. About 83% of non-responders had “exploding” headaches and 84 of responders had “imploding” headaches. Fortunately, many more patients suffer from imploding headaches or headaches with pain in the eye than with “exploding”headaches.