I don’t have PV , but have been diagnosed with ET with JAC 2, and have had balance issues for years. My balance physical therapist diagnosed me initially with a unilateral Left vestibular deficiency in 2014, but those balance issues progressed until in 2024 I was diagnosed with a Bilateral vestibular deficiency. I was never advised, nor did it ever occur to me that the blockages in my inner ear canals causing falls , could have been due to advancing high platelet counts over the years! I was told that the blockages were possibly due to using antibiotics for sinus infections caused by scarring. Years later a P Therapist said they no longer saw that as a cause; that it might be due to aging. By this point, at 82 years of age, there’s no way to really refute that. However, your question leads me to wonder if the platelets blocked those narrowing canals!