Head shaking, blotchy fins, light patches

The freshwater dip will provide temporary relief for the ich but it will be short lived.

I think you are confusing this with velvet. FW dips don't affect ich at all, since the parasite is embedded in and protected by the fish's epithelium.
 
OP- hows your regal now? Has the head twitching get relief? I just got mine and he is twitching and flashing. I'm currently on a regular dose of prazi, but am going to try the double dose.
 
Head twitching is mostly gone - he used to completely spaz out and dash across the tank frantically, and I haven't seen him do that in a while. I do think there was a flukes issue, and I think the multiple rounds of prazi cured it. I think the remaining occasional head twitching may be from ich irritation.

I am in the process of removing all fish from the tank and running them through TTM with 3x formalin dips throughout the process. I am also treating most fish with NFG during the TTM process. I am hoping that some of the blocthyness is just a secondary symptom of ich irritation... and if not, I'm hoping formalin and NFG will take care of it.
 
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