The suspect in the stabbing deaths of a middle aged Toronto couple appeared confused and injured during his first court appearance on Friday.

The man, charged in the deaths of Nazifa and Rahimullah Shahghasy, had a red mark on his neck and a bandage covering his left arm when he arrived at a Brampton courthouse, the Toronto Star reported. It was his first court appearance since his arrest ten days ago.

His lawyer told reporters he is recovering from a "significant neck injury."

The suspect was remanded in custody until May 28, when he will appear in court by video link. He is being held under guard in the medical wing of Maplehurst Correctional Complex.

Police said the Shahghasys were running errands at a plaza in Brampton on April 30 when they were targeted at random by a male suspect.

While Nazifa was inside a dentist office, her husband went next door to go and buy some food. It was when she was walking back to her vehicle that she was attacked. He rushed outside to help her, but was overcome by the suspect.

The suspect was admitted to hospital after police found self-inflicted knife wounds on his body. He had been Tasered to prevent him from hurting himself any further.

Both victims, who had come to Canada from Afghanistan 20 years ago, were in their early 50s and lived in Brampton. They died at the scene.

Dwayne Robert Palmer, 28, was charged with two counts of second degree murder.