Could be systemic scleroderma, mitral valve prolapse, pulmonary hypertension or hyperadrenalism,
It could be occipital nueralgia. You can have simple nerve test done to see.
Oh! Have you tried e-stim (electrical stimulation) for the pain?
Also, low-dose ssris or tricyclic antidepressants can help with nerve pain (by replenishing the neurochemically the pain burns through, I think).
And have they tested you for vitamins B12 and D?
Weird. Sounds a little like RSD, but not. Or shingles, but not.
Have you had a second opinion from another neurologist? Primary or not, the stenosis could cause a lot of the problems. If they could do anything for that .. it'd help, at least.
Also, some labs are much better than others with Lyme tests. And various criteria are used. (A lot of labs and doctors use the CDC epidemiological tracking criteria, which the CDC itself says should not be used diagnostically. The lab developed those guidelines to track Lyme ages ago; it knows more about it now, and would pick different tracking criteria ... but it has decades of data using the old criteria, so it's stuck.)
Ask to see the full lab report from that Western blot, see which bands were positive. (You can find more info at LyndNet.org)
You might discuss adding some of the antiinflammatory foods to your diet. Fish oil, ginger, turmeric, cayenne. Surprisingly effective in some recent studies. And cheap, easy, safe.
You might ask for a trial run of antibiotics, in case it's Lyme or some other infection. (Some people don't test positive for Lyme until they've had antibiotics. Weird, huh?) You might ask to be tested for some of the other tick-borne illnesses.
Good luck finding it, whatever it is!
(I had Lyme ... with the balance problem, facial paralysis, spatial ataxia, aphasia, rashes, itching, hair loss, fatigue, weajness, brain fog, and lots more, most of which went away after ridiculous amounts of antibiotics. I'd have done better if it hadn't taken 3 years to diagnose, so I know how frustrated.you must be.)