After conducting an extended hunger strike, Georgia’s detained former president Mikheil Saakashvili was subjected to “torture” by being denied sufficient medical treatment, his attorneys told a court hearing Wednesday.

The pro-Western opposition leader, who led the small Caucasus nation from 2004 to 2013, was imprisoned in October, just days after returning to the country from a self-imposed exile in Ukraine.

The 54-year-old then refused food for 50 days to protest his imprisonment for abuse of office, a conviction he has denounced as politically motivated.

Independent doctors said at the time that his health had been seriously damaged as a result of ill-treatment in custody and his hunger strike.

“The failure to provide Saakashvili with adequate medical service is a form of continued torture under international law,” his lawyer Nika Gvaramia told the Tbilisi city court hearing.

Saakashvili is being tried on charges of illegally crossing into Georgia from Ukraine, where he gained citizenship in 2017 and held several government posts.

He could be jailed for up to five years if convicted in the closely-watched case, which has added to political tension in the former Soviet state.

Saakashvili himself looked pale at the hearing, his once jet-black hair turning completely grey.

At one point, he asked for medical assistance and briefly left the courtroom, aided by guards.

He said he was currently “of the same weight as during the most critical period of the hunger strike”, and that he lost 12 kilograms (26 pounds) just over the last several days.

“On Sunday, I lost the use of my legs and was unable to walk,” he said, adding that he was in pain, unable to eat, suffering from persistent fatigue and poor sleep.

“I wouldn’t have been able to attend the hearing if not for an injection of a strong analgesic,” he told the court.

Saakashvili was active in Ukrainian politics after moving there when his second and last term as president ended in 2013.

In 2020, Ukrainian President Volodymyr Zelensky appointed Saakashvili as his senior advisor on reforms.

He had earlier served as governor of Ukraine’s strategic Odessa region, where he focused on trying to fight corruption.

In 2008, Saakashvili faced Russia’s invasion of his four-million-strong Black Sea nation, a war that marked the end of hostilities with Moscow over Tbilisi’s pro-Western stance.

The Georgian government’s treatment of Saakashvili has been dubbed “not just selective justice but apparent political revenge” by Amnesty International.