An assize court in Ghent on Friday hears a 53-page charge-sheet against a young Belgian who disguised himself as Batman foe "The Joker" before going on a killing spree at a nursery four years ago that chilled the nation.

Kim De Gelder, now aged 24, will be formally charged with killing two infants and their 54-year-old minder in an attack on "Fable Land" day care centre in the town of Dendermonde in 2009.

He will also be accused of murdering an elderly woman in a separate attack a week earlier, and be charged for attempted murder on 22 people, including 16 babies and toddlers at the creche.

The jury of eight men and four women will be told by the prosecution that after initial disagreements, psychiatric experts had deemed the accused could stand trial as he was "able to distinguish between good and evil" when the killings took place.

The charge-sheet shows how the then unemployed 20-year-old, son of a nurse and of an inspector at the state water board, planned the shocking rampage.

At dawn on January 23 he dyed his hair red and painted his face white with black around his eyes like "The Joker" in the Batman movie "Dark Knight".

Last year, US youth James Holmes was accused of killing 12 people and wounding 58 in a cinema screening the sequel of the film.

Once disguised, De Gelder filled a bag with knives and an axe and cycled to the nursery in mid-morning where he said to 54-year-old minder Marita Blindeman: "I have a question, can you help?"

"Without warning," says the charge-sheet, "the young man began to knife her." She did not survive.

In the nursery he then went for six-month Corneel and nine-month Leon. And then, in a bloody rampage that last a quarter-hour, attacked the remaining children and adults before making off on his bike.

Police said he had planned to attack two more nurseries, a police academy, and even the king. But he was picked up an hour later by an officer.

The young man will be present in court Friday but is expected to be interrogated Monday. The trial is scheduled to last until March 22.

The main thrust of the hearings will be to determine whether he can be judged responsible for his actions.

His lawyer has said he suffered from "psychological problems" as a teenager and heard "voices in his head."

His parents had asked to have him committed when he was 18 but his psychiatrist had turned down the request.

The parents however lost a case against the psychiatrist.

Thousands of people turned out at the time for a march to pay tribute to the victims of the attack.