I have also been confused about this issue. It´s unfortunately possible to have both. The lyme can also make you feel like things are moving in your head. There can also be coinfections like bartonella, babesia, mycoplasma, erlichia etc in your body that can give strange symptoms. From the people I have asked with lyme there are several that feels similar things and also sharp needle like pains in the head is common.

Sometimes Antibiotics work really well if you are early on in the disease. It´s probably good to use flagyl a lot in that case, since it´s the only Antibiotic that disrupts the cysts. There are also herb protocols like buhner and cowden that seems to be working for some people and rife works for some as well.