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It’s very stereotypically old womanish and ugly in Italian, and I can’t really get past that.

I loooove this name. It could be because I'm from a younger generation and don't really recognize the character but I don't see what's so bad about the association. Also I'm hispanic and this name is more common with Spanish speakers (yet still a bit rare) so I'm perfectly okay with it. I think it would make for a better middle name though, in fact I named a character of mine Leonora Elvira.

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Some combos
Elvira Undine
Elvira Ingrid
Elvira Abelone
Elvira Dominga
Elvira Agnessa
Elvira Annelise
Elvira Onerva
Elvira Tzipora

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Etta Elvira
Mireya Elvira
Zenaida Elvira
Dorinda Elvira
Rowena Elvira
Edina Elvira
Iskra Elvira

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Brothers to Elvira
Enzo
Aquila
Vitus
Apollo
Uriel
Hiram
Iskander
Augustine
Artem
Idris
Onésime
Valentin
Amos

I like Elvira, but I think it's very different stylewise from Ursula. I'd expect a brother to Elvira to be named something like Albin, Oscar, Hugo, William, Max, Sixten...

Elvira, Queen of the Night is my one and only association, which is campy and not terribly positive. I was actually reading an Agatha Christie recently where one of the main characters was a teenager (in the 60s) named Elvira, and I found the name very jarring throughout the novel. I'm also not really a fan of the sound. It does have a neat possible meaning, though. For some reason, pairing it with Ursula makes me like it better and removes it a bit from the camp association...but of course she wouldn't always be joined at the hip with her sister.

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I love Ursula. I just do. To me the sea-witch connotation is positive because Ursula in the Little Mermaid had so much presence and was so zestfully evil. She was a villainess who was having real fun. Given that she was fat, though, and given that Ursula means "little bear," I wouldn't bestow this name on a girl who was likely to be heavyset.

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For a brother...Gerard? Harold?

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For a middle name, maybe Margaret or Margo.

I think the sounds are nice, but yeah, in America both of those names have strong pop/cult culture meanings. Both of them get these very sexy, goth vampire/witch vibes. They're kind of names that you mostly would see on characters or caricatures, but rarely on a real person.

I like the elfin vibe that I get from Elvira and love the meaning. As RoxStar mentioned, there is an old horror film hostess that is also associated with this name, which may be a drawback.

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Pairing Elvira with Ursula plays up the mistress of the dark association more than other combos would. Plus, Elvira's character was a generally witty and warm hearted sexbomb while Ursula was a jealous, conniving wannabe. I would not want to be an Ursula with an Elvira sister.

It definitely does not work in the US. Elvira is very associated with a woman who used to host horror-movie marathons on late-night TV. She called herself Elvira Queen of Darkness or something similar and was done up as some kind of sexy witch or vampire. It's an old reference but she's kind of a cult figure still, and you can see Elvira costumes at Halloween.

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There's also a very popular, very annoying country song from the early eighties called "Elvira" by the Oak Ridge Boys. Even non-country fans know this song.

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And Elvira and Ursula together sound like a pair of witches, because Ursula is the sea witch in The Little Mermaid.