We report a case of sudden unexplained death in epilepsy (SUDEP) in a 72-year-old male with newly diagnosed temporal lobe epilepsy. The patient was admitted to a regional hospital following tonic-clonic seizure for 45 seconds and ongoing acute confusion, with a 3-day history of vomiting, nausea and headache. His past medical history included hypertension, chronic kidney disease and prostate carcinoma in remission. On admission, the patient was agitated with blood pressure of 240/150mmHg and sinus tachycardia at 150 beats per minute. The patient was investigated for seizure and delirium. Electrocardiography and bedside echocardiogram were unremarkable.