Not sure what would be classified as "severe brain involvement". I had brain involvement to the point where neuropscyhological testing showed I'd lost 15 IQ points. I could not follow a 20-minute sit-com, read a book, or drive. Basically I spent my days and nights sleeping or trying to attend to basic tasks like showers, laundry, and food.
What kind of Dr are you seeing? A rheumatologist should be treating you with Plaquenil and one of these (Imuran, Cellcept, MTX). If none of those 3 have helped, there are even more serious medications. But you should certainly be given more than Prednisone and Tylenol.
I spent the better part of 3 years trying the different medications, etc, before Cellcept was my miracle drug and gave me back my brain. It couldn't give me back my business, my PhD, or make me run marathons again, but I have a grateful life.
Let us know what the Dr says.
Lynnwood, Lupus & Sjogren's Moderator, Dx: 2000DIAGNOSING LUPUS & HW's LUPUS 101
"Life is far too important to be taken seriously." - Oscar Wilde